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I have been reading with interest the debates about 12 Step recovery on the various blogs at Wired In. Although I quite agree that attacks of the kind David Clark is concerned about have no place in this community, I believe some of the points made by the “anti-AA” posters are valid and need serious consideration.
The main issues appear to me to be about:
As a therapist, I’m particularly concerned about the second issue, and I’m very aware that experiences of indoctrination, fear of expressing divergent views, sexual exploitation ranging from fairly minor to extremely serious, and being given misleading information or advice such as to discontinue needed medication, are not that uncommon in the 12 Step fellowships.
I don’t think people who experience these malpractices should shut up about them. I also believe it is my duty as someone supportive of 12 Step recovery (in its safe, inclusive, tolerant form) to help any client recognise and rebut misleading advice and to protect themselves from exploitation and indoctrination.
None of these experiences, which undoubtedly occur in many human groups, are in accordance with the 12 Step philosophy and the fellowships have issued guidance in many of these areas which our clients should be made aware of.
I also want to state unequivocally as a supporter of the 12 Step movement that I consider actually forcing people to go to AA or NA, as appears to be the practice in some situations in the U.S., for example after a DUI, or in order to get parole in prison, or emotionally forcing them by threatening that if they don’t they will not get better and will likely die, to be outrageous and utterly unacceptable.
As far as the research evidence is concerned, I notice that representatives on both sides of this debate cite research extremely selectively. Often outdated, out-of-context pseudo-information is presented as authority for one’s opinion.
I have seen various examples, some of which clearly originate in a kind of online manifesto published by someone who calls himself (or herself) Agent Orange. The so-called “Orange Papers” are in parts intelligent and cogent critique of the more egregious absurdities in the 12 Step literature, but the way in which the author uses so-called research evidence is extremely dubious, and despite academic-looking references, the inferences and conclusions drawn are either illegitimate or irrelevant to the current situation.
What is certainly true is that in the last 20 years the research situation has radically changed in regard to both 12 Step recovery and so-called 12 Step facilitation (which is professional intervention designed to encourage affiliation with the 12-step fellowships).
Many high-quality studies are emerging both with drug and alcohol clients, with young people, ethnic minorities and different genders. The great majority of these show positive outcomes associated with 12 Step affiliation.
Of course, this does not show that this is the only route to recovery, a perfect system, something that works for all clients, or something immune from problems, but that cannot be said of any intervention.
The eminent researcher Keith Humphreys said to me in a personal conversation that in his opinion, “The research community owes AA an apology”. Dr Humphreys is by no means biased, and came into the addiction field from another area of psychology, but he feels that the 12 Step resource was extremely misleadingly represented by addictions researchers, really until the results of Project Match were published in the mid-1990s.
As to whether AA, NA and the other 12 Step fellowships are religions or cults, I must say that in my view they do share many characteristics of religious groups. The programme, even if you secularise the ‘God bits’ (Good Orderly Direction etc), remains clearly what used to be called moral psychology, which is quite close conceptually to religious practice.
Many have commented that psychotherapy and self-improvement are the chief religions of the late 20th century in the Western world. The 12 Step version is rooted more in a Protestant philosophy of limits, and an ethic of mutual responsibility, than in the arguably self-indulgent psychotherapy of liberation (‘do your own thing’, ‘get in touch with your feelings’, ‘feelings are the most authentic form of self-experience’, ‘you are entitled to anything you want – you just gotta aim for the stars’) which became fashionable from the 60s to the 90s, and which actually influenced addiction treatment very profoundly, in my view with mixed results.
However, and this may vary from region to region, my personal experience of 12 Step groups in England (11 years from 1983-1994) was that they had some quite unique cultural features, and expression of and tolerance of different views and interpretations of the programme was quite easy to find.
Of course, there are AA/NA groups and individuals characterised by a more rigid and often a crypto- (or not so crypto-) religious outlook, but I had no difficulty avoiding these, and I often help clients who are worried or intimidated by such things how to a) find more congenial and constructive companionship in the fellowships, and b) how to recognise ‘toxic’ sponsorship and damaging advice.
AA and NA are cultures if not cults and they vary widely. Klaus Mäkela edited a great book called ‘Alcoholics Anonymous as a mutual-help movement – a study in 8 societies’, which clearly shows that even the simplest practices of AA vary considerably across countries.
Interestingly, an online commentator who wrote about what is was like as an atheist in 12 Step recovery in the U.S. remarked that he found more tolerance and respect for his atheism in NA than in AA.
As a lifelong atheist myself and someone who simply does not construe the world in spiritual terms (unless you convert the meaning of ‘spiritual’ to mean ‘emotional’ or ‘sentimental’), I could never have found a happy place in NA unless I had found a flexible, tolerant, friendly culture that didn’t insist on particular views of the world.
The phrase from the NA text that saved my life was ‘There are no musts in NA.’ I took that on trust and recovered. I know there are many types of people in AA/NA/CA etc.
I myself don’t particularly care for the ‘Deep Thoughts’ type pseudo-wisdom that many people in the fellowships seem to like, since I find it sentimental and usually meaningless, but these days I can get along with people who do like it, as tolerance and getting along are things I learned (at least partly) in 12 Step recovery.
The criticism that 12 Step philosophy is ‘belief-based’ seems to me to be silly, as of course it is. Wake up to the post-modern world! In the human sphere there are no ‘facts’: everything is a matter of belief, interpretation, individual and shared meanings.
The whole concept of ‘evidence-based policy or practice’ is an excellent example of something ‘belief-based’. If you think that you use less drugs because you have learned ‘coping skills’ or because you challenge your ‘drug-related thoughts’, this is just a set of beliefs which you have faith in, no less than believing that your Higher Power is keeping you sober. It is a set of beliefs that suits some people better than others.
The sacred text that supports your beliefs in this case (if you are familiar with the alcohol literature) is the Cochrane review or the NICE guidelines, or perhaps the NTA directive that tells you it’s ‘evidence-based’. In fact, the empirical support for this set of beliefs is as weak or weaker than it is for 12 Step recovery, despite any number of ‘Randomised Controlled Trials’, which are the scientific equivalent of miracles, and not half as much fun: ‘See the RCT and thou shalt believe!’
What I would like to see.
My own interest is in Recovery (not just 12 Step) as a social project, not so much an individual one. I do think communities of recovery are forming and can form in the future which have the potential to play a significant part in regenerating communities morally (I prefer the old fashioned word moral to spiritual).
What I think would be a lot better than attacking each other, would be to see on Wired In some elaboration of the principles of non-12 Step recovery. For example, there is another great tradition of recovery which comes from the TCs (Concept Houses).
These have the concept of ‘Right Living’ (see George de Leon’s book ‘The Therapeutic Community, the model and the method’) which is seen as an essential antidote to the addicted life. The principles are not a million miles away from 12 Step principles but are expressed differently.
There must also be many individual stories of identity transformation and recovery which are independent of the 12 Step programme and of the TC tradition. I think we should encourage as much of these to be expressed and explained here as possible, and we need much more research into both the diversity and universality of recovery.
In some ways, the 12 Step recovery has become dominant in the recovery discourse because it is most visible. Nearly all the published research into recovery deals with the 12 Step variety. 12 Steppers seem more willing to share their stories, and they are often more ‘evangelical’ which can be off-putting or it can be very effective.
I got a huge amount of benefit personally from 12 Step recovery, and though for many years I have been no longer part of the fellowships, I have never lost my affection, respect and support for them, despite recognising many of the criticisms made here as having validity.
The extraordinary longevity and continual growth of the 12 Step movement is quite unprecedented in addiction recovery history.
However, we need to hear the alternative recovery stories loud and clear and in quantity until they are not seen as quirky or exceptional (I know there are some on the site already), and we need to research these pathways, to restore a balance whereupon perhaps we will not need to attack each other or to feel attacked.
Thanks so much for this much needed piece, Tim. As I pointed out in a comment to my latest blog, we needed someone to write a sound, objective and unemotional blog so that we could get a clearer picture of the real issues. You have done this in your normal erudite way.
There’s a lot packed into this blog, so I’ve made a pdf so people to can print a version. Let’s hope this triggers off some less unemotional and argumentative discussion – please take note readers.
For those of you who do not know Tim Leighton (not wishing to embarrass you here, Tim) he is probably the most knowledgeable person I have met in this field. He’s also objective and very passionate about this field.
Like me, he’s a great believer in the power of the community.
Some of you may know that Tim and I have spent many enjoyable hours discussing this field (far too few though), and I am looking forward to discussion of this long blog.
“I have seen various examples, some of which clearly originate in a kind of online manifesto published by someone who calls himself (or herself) Agent Orange. The so-called “Orange Papers” are in parts intelligent and cogent critique of the more egregious absurdities in the 12 Step literature, but the way in which the author uses so-called research evidence is extremely dubious, and despite academic-looking references, the inferences and conclusions drawn are either illegitimate or irrelevant to the current situation”
The Orange Papers are written by Terrance Hodgins of Portland, Oregon, which he clearly states in several places on the site. What “so-called research evidence” are you referring to, specifically? Academic-looking references? He cites his sources, thoroughly and specifically.
Mike, I think I will blog on Orange separately, as it’s a bit of a side issue. I agree he is assiduous in citing and linking to sources but it is a mistake to believe this legitimates his arguments. I will try to explain why at some point when I have time. I like Orange; many of his pages make in my view a good and extremely thought-provoking read, but actually he uses just as many rhetorical devices as those he is attacking. I hope to illustrate this by analysing some of his statistics. I am surprised this has not been done before: most of the criticism of Orange I have seen is idiotic and ignorant mud-slinging.
My point here is that his picture of AA is not the only one. It may be that American AA or NA is more doctrinaire and more authoritarian in some ways than European versions. It certainly appears to me that the kooky manifestations and weird personalities which do crop up in the UK 12 Step arena from time time to time are pretty well marginalised and are certainly avoidable. These are very interesting and complicated sociological questions which deserve close attention.
Thanks for your comments David. As with all blog entries it was written quickly and hardly does justice to the issues. But I hoped it might be a small but constructive contribution to the conversation.
“to me” “to you”
stop holding on to it all .
cant we just connect as humans in recovery ?
how can you research something that is anonymous..?
sounds like pot jockeying masters ….?
Thanks, Tim. I look forward to reading your analyses of the Orange Papers.
Cookie, being a Yank, I’m not sure what pot-jockeying masters are all about, but I’m guessing you weren’t paying anyone a compliment. AA researches itself, as demonstrated by its triennial surveys. Anonymous does not mean beyond investigation/research. It means that members do not reveal themselves or others at the level of press, radio, and film.
Tim, thanks for this blog. As someone who has both experienced and witnessed some outrageous abuses in AA, I find it both gratifying and refreshing to run across someone in the treatment community who is willing to acknowledge that the reports of harmful behavior in the program are valid and deserve to be addressed. And thank you for agreeing that forcing people into AA is “outrageous and utterly unacceptable.”
I think there is room to discuss, agree, disagree and debate about what works and what doesn’t work in helping people to overcome addictive behaviors. But I hope that we can all agree that sexual and financial exploitation, emotional abuse, threats, indoctrination and fear are not recovery tools.
is that right?
you see this what happens when you are guessing ?
(No, Blamedenial is not my real last name) Mike?
you must see alot of yourself in me ……….? mike
mike are you unable to discern the difference between legitimate, well-founded, well-intentioned criticism put forth for the sole purposes of manifesting positive change and discourse, and “attacks”? We speak as we do because we genuinely empathize and understand the difficulties of the 95% of attendees who find the 12-step method lacking, not because we like “attacking” those who promote it. We tell the truth as we have come to understand it because we care about those who suffer with addictions and mental health problems. Our complaints about and criticisms of steppism are based on our own experiences, observations, and verifiable research. A “solution” which works for 5% of those subjected to it is no solution at all, but rather, part of the problem. There is a huge difference between helping addicts and promoting a mostly-ineffective, often-harmful methodology.
mike being americian…. ? still love you.
In relation to your last sentence, Claire, absolutely agree.
Cookie, can we get beyond this 5% business – I’ve yet to see the evidence of this low percentage helped – and talking about people being ‘subjected to’ AA. The ones I know who benefited would never consider themselves subjected to.
David, I hope that your agreement with my last sentence does not suggest that you don’t agree with the rest of what I wrote.
I for one am willing to avoid all personal invective and have an honest discussion about how we look at the research, about how we can help addicted people to regain their health, about what’s good and bad about recovery groups (including AA). This is all very important to me, because I am in the process of moving from being an attorney (I’ve been practicing law for over 20 years) towards becoming a member of the mental health community. One of the things I hope to do is to assist people in addiction recovery.
One thing I have learned in my years of practicing law is that genuine debate is absolutely impossible when people are screaming and accusing each other of lies and bad motives. That is why litigation has rules of procedure.
I can accept that we may not always see things the same way, interpret the available studies the same way, or have had the same experiences regarding 12 step programs.
But when I tell you that I have seen people go off their prescribed medications on sponsor’s orders, or that I have both experienced and witnessed financial and sexual exploitation by established AA members against more vulnerable ones, or that there is a steady stream of court-ordered individuals in AA meetings in the US who have been forced to be there, I ask you please not to tell me I am lying…because I assure you, I am not.
Claire,
Middle of night here in Oz, sadly I’m still on UK time. I agree with all that you say in last email but one – not just last sentence! I think we are very much closer in our thoughts than you may realise. It annoys me intensely what I hear being done in this field – not just AA, but other aspects of treatment. And I mean annoys me.
You have made my day (night!) telling me about your background. This is brill, we need more of you. I agree you get nowhere shouting at each other. And the world does not change with prolonged negativity.
I am totally committed to recovery field – writing a book on recovery at present – and love the work of White, Davidson, etc, etc. I don’t have time to get bogged down in some arguments as this website is a side hobby, in the sense that it is not the day job.
Look forward to long discussions with you. Where you based?
David,
I’m in the US, Pennsylvania to be more precise. Practically the other side of the world, eh?
I too am totally and genuinely committed to addiction recovery—mental health in general, actually. I find the subject endlessly fascinating, which is no doubt why I continue to seek out websites such as this one.
From David, “Cookie, can we get beyond this 5% business – I’ve yet to see the evidence of this low percentage helped – “
The evidence comes from Alcoholics Anonymous itself. AA did triennial surveys, and you can read about them here:
http://www.scribd.com/doc/3264243/Comments-on-AAs-Triennial-Surveys
At the bottom, you can see the graph showing that only 5% are left at the end of a year. (This is 5% retention rate, not 5% sobriety rate. Not everyone who attends meetings is succeeding in staying sober.)
This is not news. This is something we were well aware of and talked about in meetings. It was no secret.
I was going to meetings in Altoona, PA back in the early ’80’s. Members would say, “Alcoholism is such a terrible, terrible disease! Only one out of 35 makes it!”
(I myself thought that if only one in 35 succeeds, AA can’t work very well, but I said nothing.)
Other members had no problem with this tiny statistic. They saw it as validation of the Disease Concept, and proof that AA was right about alcoholism. They saw themselves as special, as affirmed, as chosen, as that One out of 35. Some claimed that they had been singled out to be blessed by God. It was very upbeat and validating.
This statistic was considered to be positive. And while we were talking about it in Altoona, PA, other AA members in other parts of the country were saying the same things.
So what’s the difference? Back then the 5% retention statistic was evidence of special blessing from God and something to talk about in a positive way. Now it’s considered evidence that there are problems with AA, and that AA doesn’t produce any effects above and beyond the rate of natural spontaneous remission in untreated people who never go to AA.
Cookie copied my post from a previous post and tossed some sarcasm(?) in with it. Moderators, is mockery a form of that “personal attack” you have been trying to discourage?
My apologies Cookie, I hadn’t realised you were copying comment and being sarcastic. Thanks for info Laurance.
Claire tells us, “I too am totally and genuinely committed to addiction recovery—mental health in general, actually. I find the subject endlessly fascinating, which is no doubt why I continue to seek out websites such as this one.”
I’m with Claire here. Perhaps I offend people here because I have a complicated view of what “recovery” might be, as well as how to do it.
I, too, am concerned with mental health. I am the caregiver to a dearly loved person with both borderline personality disorder and chronic pain. This person suffered dreadfully in AA and is very angry.
Now, I’m not angry, but I am interested and concerned. This person needs opiates for pain. I do not like the term “drug addict”. It simplifies what is a byzantine and complex situation, and reduces real people to stigmatized stereotypes.
If I cannot give free and easy approval to AA, it is because AA failed this person and gave no tools whatsoever to manage severe pain and the heavy burden of a major personality disorder.
Apology accepted.
Laurance, I’m interested in the whole of mental health as well. I don’t like the phrase “drug addict”, it is a stigmatising label. Thanks Mike and Cookie.
Tim, re-reading your introduction, I see that you are not entirely closed to hearing what those of us opposed to AA have to say. I hope you will give me a chance here.
I’ve said before that I was in AA for 12+ years, and that for the first nine years I loved AA and believed I’d be in AA for the rest of my life. It was my life and my family.
So what happened?
I have no problem with the happy memories of F’s jokes, and ice cream with L, and J’s poetry, and the warm, welcoming handshake from G when we came into the room. There was goodness there. I was happy to go all over central Pennsylvania for those meetings. Those memories wil be with me for the rest of my life.
My problem is with dishonesty. And yes, I understand that my saying that AA is fundamentally dishonest may be construed as an “attack”. But I see it, and I can’t pretend it isn’t there.
I would ask that we take this fundamental dishonesty seriously. It did me harm, harm that I’ve had to work on undoing.
I ask, is dishonesty the price we have to pay for sobriety? Can’t people be sober while still being honest about things.
(And just what is “sobriety” anyway? Just what is “recovery”? Total abstinence? Moderation? Harm reduction? Should AA be permitted to define what a good life is?)
We said it is an “honest program”. But I watched us claim that AA is not religion, it’s spirituality.
Yes, whatever “spirituality” might be, AA can claim it.
But the fact remains, no matter how vehemently it’s denied, that AA is indeed a religion. Not only does it fit the definitions of “religion” in the dictionary, it’s the larger and better-known of the two sects of Buchmanism. There’s a historical reason for this “spirituality, not religion” business which I suspect most AA members have not learned. I suspect that most AA members have no idea of AA’s history, and know nothing of the Oxford Group/Buchmanism.
Why, why, why does sobriety depend on claiming that AA is “spirituality, not religion”? Why would people go and get all drunked up if they were to understand AA’s history and be able to happily claim that AA is indeed a religion? They’re practicing a religion. Why should denying that fact keep them sober?
This is dishonesty, and dishonesty undermines our well-being.
We’d claim it is an “honest program”, and in the next breath we’d advise people to “fake it till you make it”.
And then there’s the problem of “drunkalogs”. It was competitive story-telling. Who is the Worst Drunk here? I’d listen as people would tell these awful drinking stories.
And we were supposed to laugh! These stories were supposed to be funny. This humor comes directly from the Oxford Group. I remember one horror story from a man who beat his wife, ripped her clothes off her and threw her out the front door. Since they lived along the highway, people driving by saw this naked woman in her shame.
Haw haw! It was funny! He’s the worst drunk here tonight!
And then there was the B___ Town Drunk who bragged about breaking up the bar. He’s the worst drunk here tonight! Haw haw!
This got its start in Buchmanism. Buchman encouraged people to tell stories that would get the laughs.
Is this kind of ugliness really necessary? Can you not get sober without abusiveness like this?
We told each other that AA is the Only Way. But is it? One size does not fit all. I knew a woman who was suffering in AA, and I gave her the address (this was in the days of snail mail, pre-internet) of Women For Sobriety. I had to do it quietly and say nothing to other people in the Program, because other ways were not tolerated.
I watched us talking in slogans. I had my doubts about slogans, and I saw people reducing genuine multi-faceted living experiences into sloganspeak oversimplifications. Is this honest? I watched as people “shared” and spoke in oversimplified slogans, and other people parroted back the same talk.
I was shocked. I’d told “my story”. And then I read an Ann Landers column (one of those advice columns in the newspaper, for those of you in England, Scotland, Ireland and Wales), and there was my same story! I read a story in a martial arts magazine – and there was my story again. I encountered my story over and over.
Were our stories genuinely the same, or did we learn to tweak and modify our stories till we were telling the same story? While we do have things in common, I came to see that we learned to talk the same, say the same things, speak AA-speak, exaggerate and sloganize the story till it was the same. I“ve seen it in these blogs. I’ve said to myself, “There was a time when I’d say this, too, and talk like this, too.”
There’s a deep and fundamental dishonesty happening. But I didn’t see it for nine years.
And what about atheists and agnostics in AA? Yes, Tim, I get that you are one of them. So was I. I was “the token atheist who got sober in AA”.
I had to pretend, I had to “interepret to mean”, I had to play word games ad nauseam. I had to put up with the hateful and ugly stuff in the Big Book about how we’re “savage”, and how we will ultimately convert. (Or is it differnt in Scotland and Ireland and England? And yet I have British Isles people on my own yahoogroup making these same complaints,)
Tell the truth! Atheists in AA can certainly stop drinking destructively (I did), but we can’t play the games without being dishonest.
I was happy in AA. I loved those people and went to meetings every day.
Then I moved from Pennsylvania to New York State.
Suddenly I was among strangers. These people were not my friends. And the talk that I’d just let wash over me before when I was with my friends didn’t sound so good any more. The slogans were trite, and the denial of religion and other realities was disturbing.
While I was having a good time in Pennslyvania for my first nine years, I was undermining myself by paying the price of loss of integrity.
Must you lie about religion? Must you speak in slogans? Must you prove you’re the “worst drunk”?
Do you have to believe it’s “a disease”? Do you have to believe that “AA is the only way”, or that “It’s what works best for the most”? Do you have to compete to prove what a drunk you are?
Do you have to revise your history so that you fit a template? Are you even aware of the extent to which you revise your history to fit a template?
Must you give up your integrity to such an extent you don’t ever realize it’s been lost?
It’s not an “honest program”. It’s a religion with an agenda.
Dear Laurance, not only am I not closed to hearing about the problems in AA but I am actively interested in seeking them out and making the information available to my students. I am familiar with 2 books in particular, Fransway’s 12 Step Horror Stories, and Peele, Bufe and Brodsky’s Resisting 12 Step Coercion. I know about but have not studied Bufe’s and Ragge’s other books. Online I know the Orange Papers, the Stinkin’ Thinkin’ site and various others. I know what happened at the Midtown AA. have absolutely no reason to disbelieve these stories – they have the ring of truth to me. I also not only believe but respond with anger and empathy to the stories I have read here, both about negative 12 Step experiences and abusive professional treatment. Nobody who is not insane or ignorant of them could possibly condone these things.
So why do I continue to support 12 Step recovery and still work to create non-coercive addiction treatment that can help (if appropriate) people to use the 12 Step resource safely and productively. There are two related reasons. First, in my 11 years of personal experience of Narcotics Anonymous mainly in London from 1983-1994, I can honestly say I never came across even a smidgen of the kind of things described. Of course it was not a communion of saints, and I am not saying that ‘13th stepping’ was unknown, but it was seriously disapproved of and seemed to me less common than you might expect. Generally speaking, values of tolerance, egalitarianism, goodwill, and friendship were better manifested here than in any other human society I have known. I hope to write something about the values of the fellowship which impressed me in more detail. These values have to be actively created, they are not just givens, and they can easily be corrupted by power-tripping, bullying, ‘for your own good-ism’. However I believe a society like AA or NA can protect itself from such corruption and remedy itself when such things do occur. NA and AA are its members: if members are committed to upholding the true principles and if there is sufficient solidarity and support, then these principles can prevail. My experience and those of my friends (men, women, black, white, from all sections of society) was utterly different from what is described by our concerned friends, but because I know America does not have a monopoly on egotism, power tripping, bullying and distorted and corrupt religiosity, I would never claim such abuses could not happen in the UK or elsewhere. I do believe we can do a lot to create a safe creative recovery community that is as inclusive, tolerant and egalitarian,and that this is unlikely to involve just the setting up of alternative support groups, but will require the reform and safeguarding of AA/NA/CA etc from within. I agree with what Mike wrote on another site that AA’s ‘official’ response to to the Midtown outrages was ‘pathetic’ and I think a lot more could and should have been done. However the responsibility for this lies with the membership itself as ‘our leaders . . . do not govern.’
By the way the AA triennial surveys are a very poor source to draw any kind of conclusions from, either positive or negative. I will include an analysis of the sampling and statistical problems of such surveys in my piece on Orange if it ever gets written! Love to all, Tim
By the way Laurance, just to respond to one of your questions. No you don’t have to believe it’s a disease to successfully use 12 Step recovery. George Christo’s and Christine Franey’s very interesting study of NA members in southern England in the early 1990s, showed that a substantial minority of members (36%) explicitly rejected a disease notion of their addiction, and explicitly endorsed a ‘habit’ explanation. They go on to say ‘Spiritual beliefs and disease concept beliefs as measured in this study did not predict drug use, neither were they prerequisites for NA attendance.’
Christo, G. & Franey, C. (1995) Drug users’ spiritual beliefs, locus of control and the disease concept in relation to Narcotics Anonymous attendance and six-month outcomes. Drug and Alcohol Dependence, 38/1, 51-56.
The integrity/hypocrisy point is also very interesting and deserves consideration. I must say I resolved the issue differently to you Laurance, but I do know exactly what you are talking about. For me I came to think that it is not possible for a human society to have a recognisable shape without as you say ‘templates’ for speech, forms of expression and behaviour. If such a society contains, and explicitly aims to contain, people of different temperaments, origins, outlooks and so on, and it also aims for unity, then there will be many situations when what people say is not actually what they think or believe. The use of words is very slippy and non-literal anyway. I once saw a Ferrari in the street in London with an NA ‘Powerless’ bumper sticker on it, which i found amusing. I must say that I have never believed in supernatural powers and I never believed that my addiction was a disease or even that it was helpful to think of it as one. For others it may be different. I was also quite aware of being able to share my story in the NA ‘template’ without ever suggesting that I did believe either of those things. I recently got married in church, and I did not feel in any way hypocritical. I did so because a) it meant a lot to my wife, and b) it represented a tradition and an aesthetic that I find important and appealing. The Church of England has had a healthy dose of agnosticism and anti-supernaturalism in it for at least 200 years, including amongst some of its bishops! Keep on truckin’, Tim
“By the way the AA triennial surveys are a very poor source to draw any kind of conclusions from, either positive or negative. I will include an analysis of the sampling and statistical problems of such surveys in my piece on Orange if it ever gets written!”
Tim, the “5%” concusion has been referenced in AA history long before Agent Orange came on the scene, or the triennial surveys report hit the fan. Nell Wing, Wilson’s personal secretery for many years, writing in defense of his LSD experiments, had this to say: “There were alcoholics in the hospitals, of whom AA could touch and help only about 5%.The doctors started giving them a dose of LSD, so that the resisitance would be broken odwn. And they had about 15% recoveries. This was all a scientific thing.” (Pass It On, pg. 370}
Bill’s own writings, speeches, and musings also suggest a very poor retention rate, from AA’s earliest times. He ran about wildly for months before bagging Dr. Bob as his first convert. AA’s New York contingent included only Bill and three others when work was begun on the Bigbook in 1938, three and a half years after his white light experience and endless recruiting efforts.
An objective look at annual and total bigbook sales, as well as the Grapevine length-of-sobriety reports, also strongly indicate an ongoing 5% annual retention rate. Bigbook sales in the US have been somewhere near one million/year for many years, yet overall US membership remains flat,stuck at about a million members. Those numbers are signigicant-AAWS sells a million books a year to a membersip of one million. Any negligable retention rate would place AA’s over-all membership on the increase, not stuck at 1992-93 levels. Sixteen million bigbooks sold since that time, and no appreciable membership gains.
AA’s own membership length of sobriety repors also indicate an approximate 5% annual retention rate. I would be happy to do the breakdown if you like.
From Tim, “The integrity/hypocrisy point is also very interesting and deserves consideration. I must say I resolved the issue differently to you Laurance, but I do know exactly what you are talking about. For me I came to think that it is not possible for a human society to have a recognisable shape without as you say ‘templates’ for speech, forms of expression and behaviour. If such a society contains, and explicitly aims to contain, people of different temperaments, origins, outlooks and so on, and it also aims for unity, then there will be many situations when what people say is not actually what they think or believe. The use of words is very slippy and non-literal anyway.”
Now, I agree that if there is to be a community there have to be some common values and smiliarity of speech and behavior. Society needs some rules and laws.
But that’s not what I’m talking about. I’m talking about excessive and destructive conformity.
I’m talking about people coming to take on a persona, a mask, coming to play a role in a play. I’m talking about some otherwise very intelligent people – university professors – talking as if they were reading from a script and repeating oversimplified, stereotyped, sloganized statements in an almost monotone voice. The real person was lost, and all that was left was the role on the stage.
I used to sit it meetings and watch what was going on. I thought, “This is like watching a play. I know what’s coming, I know how all this will play out. It doesn’t matter who plays the role. Hamlet will be or not be, Ophelia will go crazy and drown, the evil king will have killed his brother. It doesn’t matter who the actor is.”
I knew then what others have since observed. AA is about AA, and it doesn’t matter who comes or goes as long as the roles get played and the correct things get said.
Okay, now here’s the Sullen Newcomer. Let’s see how long it takes for the Sullen Newcomer to transform into the Grateful Alcoholic. Here comes the “Agnostic”, saying the predictable speech, “I haven’t gone to church in several years. I guess that means I’m an agnostic.” Give him three weeks to turn into the True Believer Who Finds God.
Now, I recognize that AA doesn’t have a monopoly on expectation of conformity. I think expectation of conformity from others is a human characteristic. We are social animals, after all, and we’re going to have to follow the rules to a considerable extent if we want society to function. I can’t keep my neighbors awake with loud music at 3 AM. I have to pay my bills and treat others with a certain amount of courtesy.
I ask how much gets lost, and how much conformity is too much. I think mainstream people don’t quite realize what life is like for those who are different.
There’s a genuine inequality that superficial tolerance cannot equalize. Black people, for example, can read white people like a book. But white people don’t have the same comprehension of black experience. As the token atheist, I was well familiar with the beliefs and values of my fellow AA members.
But they had no idea about me, and couldn’t comprehend what I was really about.
Being the token minority member in a majority society is damaging. It involves a kind of loss of self, a truncating of self so as to not lose the support of the majority. In this way I found AA very destructive, even as it was feeling good to be there.
Tim again, “Generally speaking, values of tolerance, egalitarianism, goodwill, and friendship were better manifested here than in any other human society I have known.”
Superficially I agree with you. I can tell sweet stories about having a wonderful time at happy and welcoming AA meetings. But there’s a boundary we must not cross. As long as I stayed within the boundary I could enjoy tolerance and egalitarianism.
I could say that my Higher Power is The Force For Good In The Universe. I could tell you my Higher Power is A Big Brother Who Cares For Me. It could be The Inspiration In Nature That Brings Out My Higher Self.
And of course there’s Good Orderly Direction.
I was even told that my Higher Power could be the folding chair or the styrofoam cup, as long as it was Outside Myself.
But to say I am an atheist, and I don’t believe in Higher Powers?
No way!!! That crosses the boundary, and suddenly all that tolerance and egalitarianism vanishes in a puff of smoke. Suddenly I’m the enemy who is killing alcoholics and threatening everyone’s sobriety.
I remember being shocked at the hatefulness and ugliness that these formerly friendly and tolerant people exhibited. I remember the spiteful smirking and ill will expressed towards anyone who left AA. The friendship and goodwill are circumscribed and limited. The “unconditional love” is highly conditional and will vanish in an instant if I do or say the wrong thing.
Tim again: “ I was also quite aware of being able to share my story in the NA ‘template’ without ever suggesting that I did believe either of those things.”
Oh, me, too! That’s the very thing I’m talking about. I got so good at saying the right things and putting a smile on everyone’s face.
But I’m not sure that that is a healthy thing to do. Necessary at times? Yes. But a healthy way to live on a daily basis (and for quite some time I was going to meetings every day – AA had become my family), healthy to have one’s primary relationships based on our ability to play word games so as to avoid abuse? No way.
Tim concludes, “The Church of England has had a healthy dose of agnosticism and anti-supernaturalism in it for at least 200 years, including amongst some of its bishops!”
Yes, and you have Richard Dawkins, lucky you. You live in the UK. But I live in the Bible Belt of Pennsylvania, USA, and am painfully aware of being a member of a despised and hated minority. This is stressful, and AA isn’t the loving and tolerant place it claims to be. Atheists can only be tokens, used to prove that AA works for everyone.
I want to say how much I appreciate this dialogue. I also want to say that for me it is not about ‘winning’ the debate. So I do not claim (how could I?) that my experience of 12 Step fellowship is more typical than Laurance’s. In fact I’m sure it is not. I am in fact convinced that had I been treated differently by my counsellor in a treatment centre in 1983 (in actuality with great respect and with a real and enduring attempt to understand my point of view) and had I met a different culture in the fellowship, I might well be feeling very similar to some of those expressing themselves here. I felt genuinely integrated and found plenty who thought in a similar way.
What I am trying to say is that fellowship without all this hate, insecurity, defensiveness and insistence on conformity is completely possible, because I saw it working really well for over a decade. Any one who had dared to suggest to me that being a non-believer was a a kind of ‘second best’ who might eventually see the true light would have received extremely short shrift from me. Maybe I am lucky to be in the UK. I agree that when I come to the States I find the religiosity and the almost universal taking for granted of God-belief profoundly shocking and very surprising for a country that has consistently produced some of the world’s best thinkers, artists, academics and has some of the very greatest universities.
Mike I am not disputing that most people who try AA don’t stick with it. However this has to be put in context, and the claim that this means that if AA’s retention over a year is 5% this indicates that it is no better than natural remission is so full of flaws that I don’t really know where to start. The 5% figure is very far from being established – the statistical analysis of the triennial surveys up to 1987 does not meet publishable standards by a long chalk, despite being the analysis being assisted by a Professor of Statistics. Similar or worse problems attend the other sources for this figure. However the true drop-out may be somewhere around this figure or it may not. Nobody really has any idea. I came across a statistic some time ago which unfortunately I can’t trace today, but it came from one of the really large U.S. wide government funded household surveys which showed that more U.S. residents attended 12 Step meetings in the past year than even the most extravagant claims for the total number of alcoholics in the whole country.
The Big Book sales stuff is interesting and I would like to look at the arguments for retention rate based on these. I can see several different scenarios being able to account for this, but yes please Mike send me the info. I agree that AA is probably saturated and is not growing much in the U.S. it’s a similar story here in the UK for AA over the past 10 year or so, whereas NA and CA are growing remarkably.
I have lots more to say on these topics but i will restrain myself! I think cultures can be influenced for the good, and this usually happens from within. I believe, probably misguidedly but with unquenchable optimism, that the ethos of the fellowships (and other recovery movements as well – I’m particularly interested in LifeRing) can be constantly re-created by its membership to foster and preserve genuine tolerance and mutual learning. The paranoia and judgementalism can surely be identified, resisted and defeated. What I most notice about the more entrenched voices on either side (and I absolutely do NOT refer to Laurance and Mike here) is that it seems they never change their minds. All the debate consists of rebuttal and a maintenance of the original assertions. I must say I find myself changing my mind quite a lot in this field, and critique and debate are essential parts of this process.
Laurance, Tim, everyone,
What an excellent discussion! Absolutely fascinating.
My own experience with AA was a lot like yours, Laurance. I was a very devoted member of AA for nine years and thought I would never leave. I too have fond memories of certain events and individuals. I have even maintained a genuine friendship with my former sponsor, who is a delightful woman.
So…again…what happened?
Laurance, here again, I’m right there with you. It was the dishonesty.
At first my discomfort was a subtle rumbling, beneath the surface. I noticed that when I spoke at meetings (gave my lead) I was subtly editing myself…to fit the template, as you put it, Laurance. I refused to actually lie, so what happened is that my leads got shorter and shorter.
I noticed that atheists were NOT welcomed at all, despite statements to the contrary. At one meeting, early on, a nice enough gray haired fellow was taking his turn to share. As he spoke, eyes were rolling; people were getting up for coffee; he was being roundly ignored and dismissed although he was not saying anything out of the ordinary. I turned to the woman next to me and asked her what was going on. I will never forget her response: “Oh, that’s just John. He’s an atheist. Everybody hates him.”
After these early rumblings of disquiet (which did nothing to shake my allegiance to the program) came several real cracks in the foundation.
The first was when I read about the Midtown Group in Newsweek magazine. I was horrified, because I suddenly realized that the same sorts of things were going on right in my area, although certainly not at the level of the Midtown Group. I started bringing up the issue to my program friends, and their responses were even more horrifying. Not a single one of them was concerned about the abuses that had been perpetrated in DC or the fact that similar things were going on locally; they were concerned that the bad publicity would keep people away from the program!
Next, a friend of mine in the program relapsed after 7 years of sobriety. I was part of the group who took her to the hospital; she was in very bad shape, almost died. It turned out that she had been diagnosed with bipolar disorder and had been doing reasonably well on her medications, but that she had stopped taking them on the advice of people in the program who told her that her bipolar disorder could be addressed by working steps and that her meds were getting in the way of this “spiritual” process. Predictably, the mood swings soon got out of control and she started using again.
As the foundation began to crack, I began to question the program and my involvement in it. It was the questioning process itself that finally opened my eyes.
I realized that I was afraid to think. This chilled me to the bone. I can’t quite describe the feelings I had. Anger, yes, but also a mixture of betrayal, confusion, sorrow, regret, revulsion. It was very painful.
I didn’t quit the program at that point, but I had something of the experience Laurance describes after the move to NY.
I sat in those meetings and I saw the dishonesty. I’d been in the program a long time then. I knew everyone. The program was my entire social life. And I knew they were lying.
The guy with 30 years who was waxing eloquent about his family….well, he beat his wife.
The lady with 26 years…was really drinking vanilla extract behind the scenes.
The guy who took groups of people on “recovery vacations”…was getting financial kickbacks from the tour company.
The woman who had 30 sponsees…was controlling their lives, telling them to go off their meds if they took them, insisting that they patronize her business and restricting their communication even to other people in the program.
This had all been going on, right there, in front of me, for years, but I’d ignored it, passed it off….heaven knows what I did with it but it wasn’t until I allowed myself to think that I actually saw it for what it was. And I realized that I could no longer be a part of it.
So I left. Now THAT was an experience. You would have thought I was wobbling on a ledge, threatening to jump to my death, the way people reacted. I was sure to relapse. I was signing my own death warrant. One of my sponsees cried as though I’d told her I had cancer. There were some unkind words (“how dare you take what was so freely given to you and walk away?”) and some belittling (“going to try it your way, are ya Claire? Well, we’ll be here when you come crawling back.”)
This experience has not dulled my desire to help what AA refers to as “the still suffering alcoholic”. I simply think that AA’s shortcomings are too serious to ignore. Perhaps Tim is correct and AA can somehow correct itself internally. I am not personally optimistic about this, because it seems to me that the problems with the program are rooted in its basic ideologies and practices. But if we can’t even acknowledge that the problems exist, there is no hope of solving them.
Claire
Tim says, “What I am trying to say is that fellowship without all this hate, insecurity, defensiveness and insistence on conformity is completely possible, because I saw it working really well for over a decade.”
I’m trying to get a handle on what you’re saying. What do you mean by “fellowship”?
I went to a quite number of meetings where there was no hate or insecurity. There was a really lovely meeting in a little town north of here, and I think it was good because the man in charge was good. My memories of that particular fellowship are happy ones.
And there were other very pleasant meetings/fellowships as well.
Now, how about conformity? While I was not pressured to conform at that particular meeting, I had already had plenty of abuse at the meetings in my home town. I’d learned well what goes and what doesn’t. I had already learned how to self-censor.
Now, the man I’m thinking of was good, as I said, and I don’t think he would have abused me if I’d spoken up about atheism. But I do believe there would have been enough discomfort that I would not have felt good about coming back again.
So I can certainly point to good meetings and good fellowships. But these good meetings were an island in an otherwise perilous sea.
You believe, I get, that a fellowship without hate and all that bad stuff is possible. Are you talking about AA in its entirety? Or are you talking about islands of the kind I’m talking about?
Have you read the Big Book? Have you read the ugly things it says about people like you and me? Have you read the chapter “We Agnostics”? Have you seen that it’s not about welcoming and understanding agnostics and atheists, but is about converting us? How are you going to get an organization which officially says you and I are “savage” to accept us when we don’t play the byzantine word games it takes to get along?
Tim again, “Any one who had dared to suggest to me that being a non-believer was a a kind of ‘second best’ who might eventually see the true light would have received extremely short shrift from me.”
If I were to give short shrift, I’d get even shorter shrift back, together with hateful accusations. I was in survival mode much of the time. Much as I loved meetings, I was on guard in most of them. I had to be very verbally skillful to deal with the insults and cruelties.
(We’d started a Big Book meeting. A member by the name of S hadn’t come to any of the meetings, but when it was time to read and discuss “We Agnostics”, S showed up and wanted to chair the meeting. We read the chapter, and S turned to the person on his left to start the discussion. Person after person, in order, had their say. When it came my turn to speak, S hopped right over me and didn’t give me a chance to open my mouth. After everyone but me had spoken, S said, “If there’s nothing else, we’ll close the meeting.” I raised my hand and said, “You forgot me. I haven’t spoken yet.” S looked at me contemptuously and sneered, “Oh? Does the atheist want to say something?” I did speak, but the insult was clear.
In Altoona I was at a meeting which always opened by reading the 24 Hour Book. On this evening the book was quoting some particularly ugly stuff from the Big Book about how totally horrible atheists and agnostics are. I used all the verbal skills I could command. I said something to the effect of, “This is hurtful to me. I’m hearing AA say terrible things about me which are not true. Why must AA do this to me? I wouldn’t do it to you. I wouldn’t call my Catholic friends “mackeral snappers”. I wouldn’t call my Protestant friends, “Bible bangers”. I wouldn’t say such hateful things about any of you. Why does the Big Book say such hateful things about me?”
I got away with it. While there was no really supportive response, there was no abuse, either.)
Tiim again, “Maybe I am lucky to be in the UK.”
Richard Dawkins rocks! He’s yummy!
“I agree that when I come to the States I find the religiosity and the almost universal taking for granted of God-belief profoundly shocking and very surprising for a country that has consistently produced some of the world’s best thinkers, artists, academics and has some of the very greatest universities.”
I agree. There you are with the Church of England, a state religion. And I do believe the Queen is the head of the Church, and the Archbishop of Canterbury is right after her? Correct me if I’m wrong. Yet you have far, far less religiosity, and I get that an atheist is safer there.
Here we’re supposed to have no state church, and Separation of Church and State. And yet there are times when I feel as if I live in a theocracy.
Dear Laurance Claire and Mike thanks for your continuing contribution to this thread. I in my turn also ‘get’ a lot of what you are saying. Claire I spent some of my teenage in DC and have visited several times since – it’s one of my favourite cities in the world. I also love the parts of Virginia and Maryland that border the Potomac. Thanks again.
Tim, DC and the surrounding area is indeed lovely, as is Pittsburgh (where I live—watch for us when the G-20 summit rolls around in September!). I’ve only been to the UK once, to London for a day on a side-trip from Paris, but loved it and hope to go again.
DC is only a few hours away from Pittsburgh by car, and my husband and I drive down there for weekends a few times a year. Back when I was in AA I’m pretty sure I went to one of the infamous Midtown Group meetings there. Interestingly, I didn’t see anything amiss. After all, nobody stood up at the podium to announce that their “group conscience” was that the sobriety of underage girls was enhanced by having sex with Michael Q. But that’s what was going on.
Similarly, here in my area, there are a few groups—sponsorship cliques really, with a guru-like sponsor and a flock of sponsees surrounding him/her—that are fairly notorious for bad practices such as isolationism (even from other AAs), an antimedication philosophy, sexual and financial exploitation…but you would never know about this if you weren’t involved in the community pretty deeply. Again, they don’t announce it. It just happens.
I wonder sometimes if that is the reason—or one reason, anyway—why some of us who complain about these issues are dismissed. I’m not saying this of you, Tim or David, but often, the response when I’ll mention problems with in-group abuse, is something like: “I’ve been going to AA meetings for FORTY years, and I have NEVER seen what you are talking about.”
It’s tempting, of course, since I know I am not delusional, to wonder if an AA member who says this to me is an abuser himself, crazy, or in denial. But is it also possible that he doesn’t notice? Or care? That if it never happened to him personally, he overlooks it? I don’t know.
I do know, though, that the antipathy towards Atheists is quite overt around here. The antimedication stuff and various abuses are below the radar, but Atheists are openly disdained. There certainly is an unfortunate regional bias on that point, but I hope we can all acknowledge that the AA literature is deeply reinforcing of these views; it is hard to give a different interpretation to the statement that an atheist’s state of mind “can be described only as savage.” (12&12; p 25).
All of this makes me wonder how AA can possibly be changed from within. What would it do with the literature? Would it begin to acknowledge the problems people have been complaining about? Would it change its philosophy to acknowledge that you won’t die if you leave? When I think about this it seems that AA without the literature and the dogma would be like Christianity without Christ…an interesting idea, but impossible to carry out without changing the character of the entire enterprise.
I realize I’ve rambled; it’s a cloudy Sunday and I’m engaging in a bit of escape. Thanks all for “listening”. Looking forward to continuing the conversation.
There are so many interesting questions and important points in the last few posts that I really want to respond. I have decided to start a new thread which I may call “Guarding the safety of recovery”. I certainly do not claim to have definitive answers – very far from it. The questions of the literature, whether ‘good’ 12 Step fellowships are islands in a perilous sea, whether the existing fellowships are beholden to a rotten ideology so that reform is not possible, or whether the abuses described are aberrations which can be repudiated and protected against, these all have vital relevance way beyond AA, NA and CA. There is a burgeoning recovery movement in the UK, it is an exciting and highly energetic wave which reminds me of the first few years of NA in the UK in the early 1980s. Whether this new movement takes a mainly 12 Step form or is more pluralistic, the dangers of corruption, cultism, oppressive fundamentalism, group pressure to conform and so on are quite present and need to be confronted. it is not just 12 Steps that have had these problems: Synanon turned into outrageous abuse and criminality. Some may say conjoint recovery is just a bad idea, but I do not agree – urgently needed social and political change cannot come from private, invisible recoveries. The mental health movement has made huge strides in advocating for those who suffer mental health problems, claiming rights and improving services and attitudes generally. There is a huge way to go, but improvements are palpable. The UK government has created Methadonia here (that is not a criticism of people on methadone nor does it imply a wish to deprive people of prescriptions). Many of us feel that much more can be offered to and created by recovering addicts. Responsible solidarity is essential, but so is recognition of what can and often does go wrong as Claire says.
Tim your comment regarding the second issue which has been raised is interesting. As a therapist, I too would be inclined to be extremely concerned if your views that
“that experiences of indoctrination, fear of expressing divergent views, sexual exploitation ranging from fairly minor to extremely serious, and being given misleading information or advice such as to discontinue needed medication, are not that uncommon in the 12 Step fellowships.”
What substantial evidence do you have that such practices and behaviour are ‘not uncommon’? I do not doubt for one moment that in common with any other section of society or groups of any description, there are and will be members who voice their personal and not infrequently biased and inaccurate opinions, together with those who seek to take advantage of vulnerable people; that is particularly true in addiction where personality, behavioral and mental disorders are common. However that in itself does not mean that such behaviour in AA is ‘not uncommon’, nor for that matter does it mean it does not occur; nevertheless, in this age of litigation and ‘rights’, I am not aware of any cases pending or otherwise, where AA, or any individual member, have any formal allegations relating to such practices or behaviour been made Indeed apart from the anecdotal claims of a highly vocal, and in some cases obviously very disturbed minority, I question your ability, or indeed anyone else’s to substantiate your claim with empirical evidence. In direct contrast, allegations of ‘misconduct’, ‘inappropriate’, ‘unethical’ or ‘unprofessional’ behaviour and practices in medicine and psychology, teaching and so on, are regularly reported.
Your use of the word indoctrination, which has associated overtones of cult practices, including religion, is also interesting, especially since the only requirement for membership is ‘a desire to stop drinking’, the 12 steps are offered as ‘a suggested way of recovery’, for those who choose to engage with them. There is no formal induction to them; no time scale for when they should be undertaken, nor is there, apart from those individuals who would re-write the ‘Big Book’, any coercion to engage with them. Therefore I suggest that your choice of the word indoctrination in this case is neither accurate nor appropriate.
Insofar as the needs of atheists and agnostics are concerned, there are meetings which accommodate them. Those that object to such terms as ‘a power greater than ourselves’, ‘higher power’,etc fail, or are unable, to recognise or acknowledge, that they have already encountered such a reality in the form of their substances of use, the difference is the latter has inflicted considerably more harm on them than the word ‘God’ has ever caused anyone. I would suggest that for those of a secular disposition that ‘God’ could be viewed as a mnemonic for ‘Good Orderly Direction’ and I have yet to meet an active addicted person whose life would not be improved if they were able and willing to consider a change from the existing chaos that in the majority of cases is characteristic in those who are unfortunate enough to become addicted.
My views of the effectiveness of AA are based on the published research, personal observation of what goes on in the hundreds, if not thousands of meetings I and my clients have attended; a close study of the steps, not just their titles, and the wisdom of the universal principles contained therein, together with the personal experiences of my clients, to whom I suggest that regular attendance at AA meetings will provide a foundation not only for avoiding relapse but an enjoyable and lasting recovery. It is true to say that over a not inconsiderable number of years, I have yet to have a relapse among my clients, who not only attend AA meetings, but also opt to actively engage in the 12 step process. By the same token those who did attend but have relapsed, were unable to tell me which particular step they were engaged with, at that time. It is also true that those who do not attend are a valuable and ongoing source of income, not necessarily because they are still using or drinking, indeed the majorities aren’t, but simply because they have difficulty in adjusting to the harsh realities of life.
Notwithstanding my views there are major drawbacks with the AA program, not the least of which is that it is unlikely to work with those who are unable to mentally or physically unable to engage with it, it is for those reasons that AA via its published literature advises and actively encourages those with problems other than alcohol to seek the relevant professional help. AA is non professional, the fellowship itself, does not offer any medical or psychiatric advice or guidance. My advice to anyone new to AA or contemplating attendance, is to avoid individual members who might claim to be able to do so. The other major drawback is that engagement with the steps requires rigorous honesty, a virtue which in itself appears to be alien to those raucous voices whose principle aim seems to be futile attempts to discredit a fellowship which has withstood much scrutiny, criticism, together with unsubstantiated and often malicious allegations from those who are aware that because AA does not engage in controversy of any nature, know they are immune from litigation for slander or libel. Despite, or perhaps because of them, AA continues to grow throughout the world and will go on doing so.
Tim, as one therapist to another, I find your views on spirituality somewhat narrow and take this opportunity of referring you to the views published by the Royal College of Psychiatrists, a copy of which is available online.
http://www.rcpsych.ac.uk/college/sig/spirit/index.asp
Finally to all those AA bashers who want to attack me or anything I’ve said, save your time; it’ll be like water off a duck’s back. I’ve been attacked for my views by experts.
Peter I am not interested in attacking you, but I have to state plainly that both here and in your many letters to DDN your expressed views are very different to my own, and the kind of pluralistic recovery that I would like to see is clearly not appealing to you. I am pleased to see for example that SMART recovery has finally got established in Sheffield and I am have just bought a copy of the new book by Martin Nicholaus of Lifering that I am looking forward to reading very much. As far as examples of indoctrination are concerned, I have been in the field for 25 years and most of my witnessing of indoctrination has been in the context of professional treatment, not so much AA as I only attended a few meetings of AA, as opposed to many, many meetings of Narcotics Anonymous. Very early on, I noticed styles of “counselling” and treatment procedures which struck me forcibly as forms of indoctrination, including ‘peer evaluations’ and other types of group persuasion, interpretation of clients’ questioning as denial, and a great deal of what I call ‘for-your-own-good- ism”. I experienced some of this as a client (not too much thank goodness) and I was trained to perform this kind of “counselling”. It struck me then as it does now as ineffective and potentially harmful. As anyone who knows me personally will attest, I have dedicated myself to challenge these practices and inculcate more helpful ones.
I am aware of the growing interest in researching spirituality and I am interested in it myself as it is clearly a very important human phenomenon. I am not aware of having expressed any views on spirituality here apart from commenting on my own construction of the world and maintaining that my position is not that unusual even in the fellowships. Whether you think my views are narrow does not concern me as you do not know me.
Tim,
Thank you for your response, together with your confirmation by omission, that you do not have any empirical or substantial evidence to support your earlier claims regarding indoctrination, sexual exploitation etc, etc, etc.
Leaving aside the irrelevance, in this context, of your views re SMART et al, with whom I have no quarrel, I find your comments regarding the ‘counselling and treatment procedures’ puzzling, since the fellowships do not claim to offer either, nor for that matter is there any suggestion in their published traditions or policy to imply or suggest otherwise. However, I would be more than interested to learn from you the locations of the ‘many, many NA meetings’ at which you claim to have witnessed such procedures, together with the ‘indoctrination’ and ‘peer review’ procedures you mention. That is not to imply that you have not witnessed such incidents, but my experience indicates that whilst such practices do undoubtedly exist, they are the exception, rather than the norm which is the opposite of what you appear to be suggesting.
I can accept, based on your own acknowledged limited experience as a ‘client’, (a strange word choice, when “no fees or dues are payable”,) that whatever you personally experienced during that brief time’ was unacceptable to you. However, your personal views do not constitute fact or evidence and to posit them as such, which is precisely what you appeared to be attempting to do in your earlier submission is unacceptable from a ‘professional’; the self acknowledged capacity in which you were writing.
I admire and respect those who are dedicated, even though I may not agree with their views, however in this instance, attempts to discredit the fellowships is likely to end in frustration, anger and resentment, all of which indicate spiritual poverty, because they are not cults or religious organisations, or have any ulterior motives, as such they will continue to grow and thrive in a world where people have lost their way and are spiritually bereft.
Tim,
Welcome to my world.
Claire
to be honest Peter I have little interest in responding to your complete misunderstanding of my position. But I have to say the whole point of this blog from my point of view was to say that I do not consider the fellowships discredited by the various criticisms and concerns. I am well known, both in my publications and in conversations in the field, to take the view that i consider the fellowships a safe and valuable resource for almost all severely dependent people to explore. I am very positively disposed toward them. i clearly stated that I haven’t personally witnessed much that concerned me in NA, and professional treatment whose main aim is to foster affiliation with the fellowships is surely relevant in this context. Also it seems as if I had relayed a lot of anecdotes you would have considered that evidence. You can’t have it both ways. I am actually intending to write a blog about what I found valuable about my experience of NA and what I found more problematic, but I would never claim that this is any more than a personal view. My reasons for believing that the issues I describe are ‘not uncommon’ comes from a review of the extensive literature on the subject available both in printed form and online, not from personal experience. I do not consider this or any of the other opinions expressed in blogs like this to be matters of established quantified fact. They are not.
I thought it perfectly obvious that my reference to myself as a client did not refer to my membership of NA. I find your imputations of motive impertinent as well as inaccurate. As I said i used to read your letters to DDN, as well as those by the scientologist Kenneth Eckersley,and think “with friends like these . . . “
“Finally to all those AA bashers who want to attack me or anything I’ve said, save your time; it’ll be like water off a duck’s back. I’ve been attacked for my views by experts.”
Attack you? Heck, I appreciate you. Keep typing, please.
Peter,
Thank you for confirming the serious problems with 12-step programs. I’ll enumerate the areas where your writing provided this confirmation:
“…there are and will be members who voice their personal and not infrequently biased and inaccurate opinions, together with those who seek to take advantage of vulnerable people;” True that this phenomenon can occur in any group, but is your message that this behavior is acceptable and AA members should simply endure this risk, or should something be done about it?
“I am not aware of any cases pending or otherwise, where AA, or any individual member, have any formal allegations relating to such practices or behaviour been made”. Thank you for highlighting a serious problem with AA. For those who have been harmed, who can they turn to for recourse? Shall they sue their sponsor, an untrained layman, uncertified guide who blindly passes on either on what they have been told, or invents guidance as situations warrant? Shall they sue one of the AA central or regional groups? Who is responsible for AA, who is accountable? Why do we consistently send broken people, who usually can’t even think straight, to an irresponsible and unaccountable organization?
“…especially since the only requirement for membership is ‘a desire to stop drinking’,”. Well yes, this is definitely a problem in the form of doublespeak that is often used in AA. In fact working the steps is required; else perhaps they should be called “3rd Tradition” programs. Please note your point later in the comment: “I have yet to have a relapse among my clients, who not only attend AA meetings, but also opt to actively engage in the 12 step process.” This experience suggests that the 12-steps are required.
“…‘God’ could be viewed as a mnemonic for ‘Good Orderly Direction’ “. Well that may be a good mnemonic for ‘God’, however this concept can hardly be the higher power as defined by 12-step programs. The steps require praying for god’s will, assuming god will listen, and then asserting god’s work. How does someone pray to Good Orderly Direction? Again, your message seems to highlight a problem with 12-step programs, which is the conflict between the AA definition of a personal God and the doublespeak message that people can choose anything as their God.
“…AA via its published literature advises and actively encourages those with problems other than alcohol to seek the relevant professional help.” Thank you, after years of AA participation, I wasn’t aware of this literature. I heard so much testimony in meetings by authoritative old-timers that the only publication needed is the big book; other AA authorized material is optional. Perhaps there should be organized training or orientation for AA members, especially sponsors who should be qualified and certified.
“…does not offer any medical or psychiatric advice or guidance. My advice to anyone new to AA or contemplating attendance, is to avoid individual members who might claim to be able to do so.” Yes, this certainly highlights the problem. How would a newcomer know to ignore advice? How do we tell AA members to never believe everything that is said in AA meetings or in the larger AA community? When a new person arrives in AA, shall we tell them that there will be people who lie? Can AA add an orientation session for newcomers, perhaps a session that is developed and authorized by counselors, not by old-timers? Should new AA members be required to first see a counselor before they are allowed into a 12-step program?
“…that because AA does not engage in controversy of any nature..”. I never understood this aspect of AA. It seems like AA supporters regularly engage in controversy when confronted with evidence of problems in AA. It suggests a further problem that AA does not have the willingness to change its practices. Why is it that AA would not adopt more modern methods of recovery, why does AA resist any suggestions to improve? The reason consistently offered is that AA works as it currently is defined. Yet there is a logical flaw here, how can AA members be sure about the effectiveness of the program if they choose to ignore views from the outside? Peer review, and review by external authorities is standard practice in any discipline, yet AA chooses to specifically ignore any opportunity for improvement.
In summary, I for one believe that AA and 12-step programs have some merit and many excellent characteristics; it is the implementation of the program by laymen that is flawed and creates the problems. And of course AA is out of date. I still cannot understand why AA would not be willing to address and correct the problems, and examine methods of improvement. Perhaps AA bashing may appear to be counterproductive, yet your own writings as an AA supporter highlight some of the problems. Until we can create awareness of problems, accept and understand them, how will these problems go away, how can we possibly sweep them under the rug?
Thanks for letting me know Tim. We all have the write to decline to enter into debate with those who vex us.
I’m truly sorry you feel that I have misunderstood your position, should that prove to be the case; I would regret it even more. Equally I would ask you to consider any part you may have unwitting played in contributing to any misunderstanding. I.E. Your failure to provide any empirical evidence in support of your initial claims in respect of ‘researched evidence’ confirming that behaviour and practices which are endemic to the human race are not uncommon within the fellowships. Alongside this you indicated that you had only a brief experience of such behaviour, but in another posting you emphasised that over a substantial period of time and regular attendance it was rare to encounter such practices in NA and where they may have gone on, they were frowned on.
According to authorative and prestigious sources, the fellowships have proven over many years that their programme has been effective in helping more people to recover from addiction than all the other agencies and protocols in the field combined. I find it abhorrent that a number of individuals and organisations, many of whom have more than one agenda, seek to discredit the fellowships, with allegations ranging from condoning prurient behaviour, to ‘coercive brain washing of vulnerable individuals’. It is even more distasteful that they do so, secure in the knowledge that their views, which would be difficult, if not impossible, to substantiate in a court of law, will not be subjected to litigation. In short they are moral cowards and I will continue to challenge them.
Finally Tim, your less than subtle attempt to discredit me, by associating my name with scientology is truly pathetic. Such tactics, are are not only remarkably similiar to those used by those who seek to discredit the fellowships, they have no place in reasoned debate.They also, albeit unwittingly, reveal more about the character and moral fibre, or lack of them, of those who indulge in such tactics, than you may realise.
Thank you Tim, for all that you have written and it so good to read your open minded comments on the nature of the 12 step movements.
But I have to say that your experience with NA differs greatly from mine.
I first attended meetings of NA in London starting in 96, mostly in Chelsea.
I was overwhelmed at first by the whole social clique of it all and spent most of my first 12 months or so, using and not using and trying to detox myself at home. Hardly ever did a ‘long time’ member ever approach me, welcome me, or even talk to me! It was only ever other’ new comers’ that spoke to each other. I did almost a meeting a day for a year that way, but still could not get myself clean.
So anyway after this time and with the big ‘social outcast’ feeling I tailed off meetings and eventually got clean with the help of a great doctor and all the willingness I could find in myself, as I had truly had enough of being a very, let’s say… low end junkie!
I eventually returned to NA, (clean) and learnt all the ‘lingo’ taught myself how to share to gain acceptance and would throw in a few jokes just to please the audience!
And it worked! New best friends a whole new social life and even managed to date a few girls!! A life beyond my wildest dreams!!! But I had changed my story… and gave NA full credit for saving my life and giving me all these great new experiences.
The truth is I had learnt to adapt myself to the program not even knowing what I was truly doing, and give it all the praise I could, and not mention how awful it had been when I was shunned for using in that first year.
Now you might wonder why I am telling you all this and for what reason?
NA was a very small fellowship in the 80’s and early 90’s and had that radical element of being so called ‘cool’ and seemed very innocent and part of a new social movement in in certain London circles. Members on all night club rave sessions new comers getting 13 stepped or just ‘fucked’ as it’s more commonly known! And total disregard for any real meaning of support for people trying to join the club.
Now I am not suggesting that you were one of those people, but I do think we can have a tendency to look back on the ‘good old days’ of NA and recovery and give it so much credit and affiliation. A bit like the ‘good old best days at school’ for some who wish to aptly forget the bulling, violence, social pressure and maybe even sexual abuse and humiliation.
Sounds a bit strong, but I saw and encountered all of that in the loving fellowship of NA.
After 10 years of this I simply could not attend and give my support and endorsement to this fellowship any longer. I had tried for many years to be open and talk about these issues in meetings but was seriously swimming against the tide and found myself outcast yet again!
Fortunately by that time I had stopped ‘acting the part’ and no longer craved that approval or validation or even social acceptance of a ‘fellowship’
Now 4 years later I am free of all that, and I love being ‘clean and sober’ but also free from the nightmare that I found in NA.
Best Wishes
Mack
Can I just say also!! That I still totally respect the fact that many other members may have totally different experiences from mine, and I am not discrediting their opinions or yours. I posted my comments here as I can only say that I can’t give my support for the 12 step movement any longer and think by the very nature of the steps and traditions that nothing can really be changed from within these fellowships. But I do think that what is now being termed ‘anti-AA’ or AA bashing’ is a total Misnomer.
Just like the ‘fellowships’ can be a place to identify, I also think that the other awareness groups give support and ‘fellowship’ for those who have had negative experiences and who just simply do not want what these 12 step movements have to offer or who are being pushed by courts and treatment centres to attend.
I think that it is great that you are open enough to listen and make debate, but in my opinion I do not think any social awareness or debate on these issues of pro or against will make any difference within these ‘fellowships’ I can only vote with my conscience and give my support or endorsement with my own experiences. In practical terms I could no longer give advice to some one seeking help, to attend 12 step programs, but with so much new awareness and just as good or even better methods of recovery made possible and available. I can at least point them in a direction that could be safer than 12 step groups.
Again I really do value what you say and glad that there is a place here to all comminicate without anger and ‘I am right you are wrong’ type debate.
Best wishes
Mack
Hello, Tim…you said you were going to discuss your thoughts about Agent Orange’s website.
You also gave me the impression that you have a problem with AA’s triennial survery and the 5% retention rate which it shows.
Are you going to address this?
Tim, you also mentioned starting a blog about “Guarding the safety of recovery”. I’d like to encourage you to do this—it would be a great topic.
Hi Laurance and Claire. Yes and yes. I have been a bit busy recently.
To be honest to seriously critique the research that I rashly said I would will take a bit of time, even though I am pretty familiar with it and since I have acted as a peer reviewer for the journals Addiction, Addiction Research & Theory and Drug and Alcohol Review I do have some skills in evaluating research. I am also wondering what the point of this would be. I am extremely aware that people’s minds are not easily changed and I am not sure that is what I want to do anyway. So you might have to wait a while for my views on these.
I am trying to make the point that trying to battle each other with ‘evidence’ of whatever kind is kinda futile, as, as Nietzsche pointed out very convincingly, human beings are not really rational, and the post-enlightenment attempt to prove (in zillions of creative ways) that they are so, has not been very successful.
As far as the safety of recovery blog is concerned I think that is quite important and I will start something pretty soon (or perhaps somebody else could get it started).
Mack: thanks for your posts. They are very helpful and you make some vital points. I am aware that people have very different experiences and follow different journeys. I am also interested in the historical aspects of how the recovery experience can vary depending on local conditions.
I do think recovery can and should be ‘cool’. I was involved in a very young fellowship in London with a great deal of energy and mutual concern. it was pretty inclusive at the time. There were a few ‘clubbers and ravers’ in the late 80s NA London scene. Some were excellent role-models for recovery, some may not have been.
One of the reasons I am excited about what is happening now is that I think recovery may become ‘cool’ again but to a much wider section of society. this has some dangers but also some amazing positive possibilities.
Thanks to all for your posts. Bye for now. Tim
Also Mack, I did know a few people who had a similar experience to yours even in the ‘Golden Age’ ;-)
Many of us did try to welcome and include newcomers as a top priority, but I know people did sometimes come to meetings and get ignored, as several have told me so.
However an anecdote will give a flavour of the culture of NA as I experienced it. I was at a meeting in Primrose Hill in around 1987, with about 12 men and women present. The guy doing the main share started off by saying that his early shares in NA had been more or less a pack of lies. He said that this was mainly due to pressure in his treatment centre to produce in group therapy sessions more and more impressive examples of ‘powerlessness and damage’, so in the end people just made them up or exaggerated them, and also because he thought that he needed to elaborate his story to be accepted and liked.
Virtually everyone in the meeting identified with this, whether or not they had been to a rehab centre. This led to an interesting and useful discussion about what real honesty was and how this was often compromised by the apparent demands of the situation. We all agreed that it was quite possible to resist these demands and that it was clearly in the interests of our own personal growth to do so.
This irreverent deconstruction of NA ritual did not apparently lead any of the attendees to relapse. In fact I am in direct or indirect touch (hooray for Facebook!) with quite few of them 22 years later and they seem to be flourishing. Some still go to meetings, some don’t.
This type of openness was much more typical of the meetings I attended than tent-show revivalist cant. Many other meetings were very emotional: I remember one in Hampstead where a guy, already a long standing member, was brought in tears and near collapse by a friend after his son had OD’d on smack on Christmas Eve. However even this meeting was completely free from clichés and sentimentality, and was in my very vivid memory a nerve-tingling experience of human caring and support. The guy stayed clean through this experience, and for some years afterwards, although I do believe he later relapsed and died as a result.
No mutual aid isn’t a magic guaranteed solution, but it can be made into something very valuable and precious.
Hi Tim,
Thank you for taking the time to respond to my posts, and for ‘sharing’ your own personal experiences of NA. I bet you were one of those ‘all night ravers’ in the late 80s!!! but too ‘cool’ to admit it now!!
I think it is good that we can all talk about our individual experiences, and without a doubt human empathy and love goes a long way in helping anyone who is in the pain of addictions and recovery and even more importantly ‘life’ itself. So anyway… Chelsea crew were always ‘cooler’ than hampstead crew!!!
Best wishes
Mack
Concerning a critique of Agent Orange’s information and the 5% AA retention rate, Tim tells Claire and me, “…I do have some skills in evaluating research. I am also wondering what the point of this would be.”
Wow! It sounds like “Nyaah nyaah…I know sumpin’ you don’t know, and I’m not tellin’!”
I get the message. You know Agent Orange is wrong about a number of things, but you aren’t going to waste your time on correcting any misinformation.
Tim continues, “I am extremely aware that people’s minds are not easily changed and I am not sure that is what I want to do anyway.”
You know, we who are anti-AA say the same thing about 12-steppers (even though it’s not entirely true).
I’m hearing you say that we’re a lost cause, and there’s no point in making any effort to inform us. We aren’t easily able to change our minds about anything, so why bother with the likes of us?
And yet, so many of us, perhaps a majority, who are part of the anti-AA movement were once pro-AA, were once active in AA and AA meetings. We’re anti-AA because we opened our eyes and stopped pretending, and we saw the serious flaws. We changed our minds. It’s happening every day.
While perhaps most people never change their minds about anything, many people do. I changed my mind about AA, even though I’d been a deeply committed 12-stepper and believed I’d be in AA all my life. I’ve changed my mind about Buddhism, I’ve changed my mind about the Duluth Model, I’ve changed my mind about treatment of BPD, I’ve changed my mind about acupuncture and rolfing and other such techniques, changed my mind about a lot of things; at age 68 I’m not the person I was at age 27.
Granted, you’ve said that minds are not easily changed; not impossible to change. Still, I have the funny feeling that Claire and I have just been blown off.
Tim,
Thanks for following up on this blog. It remains a very important subject.
However the tone of your latest entry does raise some concern since it suggests there will be few if any efforts to continue understanding the situation with AA. I don’t mean to misrepresent the intent of your entry, but it does sound a bit like sweeping things under the rug.
The efforts to publicize the problems with AA are not going to fade away. In fact, they will likely become more prominent. Consider this article (here in the US) where a very well known celebrity came out of AA and published his experiences. http://blogs.suntimes.com/ebert/2009/08/my_name_is_roger_and_im_an_alc.html. Although the essay is in support of AA, it very clearly publishes the existence of significant problems with AA and acknowledges a body of people who are critical of the program.
Almost everyone has agreed that there are some good points to AA. The question remains what will be done about the damaging and harmful parts. Most who are critical of AA are very clear that the harmful concepts significantly overwhelm any benefits. AA needs to come out of hiding, it needs to stop protecting itself through a false use of the anonymity concept. I think as knowledgeable people, many of us in the recovery industry, we are obligated to expose the harmful parts of AA, and constantly improve recovery methods. Perhaps one of the most significant ways to help people is to educate people on the damage that AA can create, work to remove these harmful aspects, and promote alternatives.
Roland
Hi Laurance! All I can say about your last post is that I’m really surprised by it. It’s not what I meant at all. My comments are genuinely never meant to be cryptic comments about any individuals. if I am talking directly to or about someone I will name them.
What I got from Orange mainly is a heads-up to some of the truly extraordinary things in the Alcoholics Anonymous book. His page on ‘funny spirituality’ is very useful, and I have used it in my class teaching.
I was given a copy of the Big Book in 1983 but despite a few attempts I never read it as I found it completely unreadable. It seemed a classic period piece, and the chapters I dipped into such as ‘To wives’ and the agnostic chapter seemed paradigms of sexism and facile philosophising in a style that I found very off-putting.
However as I take a cultural-historical view of these things (I did then too but I didn’t know that it was called that) I think the qualities of the AA Big Book and the characters of the old-timers are utterly irrelevant to the culture of recovery today, except insomuch as there are people today who SAY they are important or crucial or whatever and how these people exercise power and authority.
What attracted me to the 12 Step recovery movement as I experienced it was indeed its explicit insistence on egalitarianism, freedom of belief, autonomy of local fellowships etc. etc, and even Bill W’s statement in his last speech that AA will and should evolve and change. Whether I admire Bill W or not, whether he meant what he said or not, makes no difference to how this idea can be taken up and used to create something good. I felt and still feel that the members of a mutual help movement can actualise these values or not, live them out or not, and that abusive power can be resisted. I am aware that this was and probably is much easier in my environment than yours, but it is still possible. What I maintained throughout my membership of the fellowship, and what I still hold to, is that the membership is individually and conjointly responsible for the culture of recovery. and yes this means locally, as the point of recovery mutual aid as I understand it is not to be centralised. It must meet local and contemporary needs and therefore it must be flexible.
As far as critiquing the research is concerned, if I am making claims to scholarship, I have to do the work. I readily cop to laziness and/or lack of time but I am not blowing anyone off.
To give a little taster about the AA triennial surveys, and I am not denying that there probably is a large early drop out rate, here are some preliminary thoughts:
Towards the end of the paper we find:
“There are, of course, many other ways in which the sample averages could differ from population averages in ways other than sampling errors. The population itself is that of groups registered at the General Service Office, and there are many other AA groups. One study done in 1987 suggested that about 20% of groups registered with intergroups and central offices are not registered at GSO. There are groups not registered with any of these.
There are undoubtedly members who, for whatever reason, do not complete the questionnaire; they may constitute a set with other significant differences. Moreover, only about 2/3 of the groups that were selected actually participated; perhaps they systematically differ in other respects.
The method of distribution of the questionnaires was through the 91 area delegates, so that, ipso facto, there were differences in administration of the questionnaires. There are undoubtedly other factors at work
Nevertheless, the consistency of results over the years, exhibited either as stationery values of some attributes or systematic trends of others, suggests that all sources of error are not sufficient to render the results without meaning.”
I have seen many such claims in the discussion section of papers when talking about the limitations of a study. This one is a fairly serious admission that the meaning of the results is indeed extremely uncertain.
If you look at the regional variations I think it becomes clear that the data is quite deficient. Claims made about the significance of the confidence limits seem very vague. Just looking at the table makes me feel that a proper analysis of variance is needed.
Later in the paper various statistical operations produce claims that could equally well be used to suggest that AA is quite successful, particularly if one considers the enormous number of people who actually do try AA. I have to say at once that I do not consider any such suggestion any more valid than the suggestion that this study discredits AA as a recovery resource.
These claims are as follows:
1. About 41% of those sober less than a year will remain sober and active in the fellowship another year.
2. About 83% of those sober less than five years will remain sober and active in the fellowship another year.
3. About 91% of those sober five years or more will remain sober and active in the fellowship another year.
The authors of the paper repeat their usual rubric about consistent findings over the period of the surveys, and furthermore they correctly point out that these figures must represent lower limits of the number that remain sober as presumably there are some that remain sober but do not remain active in the fellowship.
Later on in the paper, referring to these last calculations, the authors state “it should be apparent that such calculations are the development of an approximate description of average properties of the AA fellowship, and by no means rigorous statistical findings. The methods are more akin to those of operations research or systems analysis. They are useful descriptions for the use of the fellowship that average is so broad that professionals may wish for more detailed research that is beyond the purposes and traditions of AA.”
This is what I feel about the whole paper and to use it to shore up arguments for or against is unjustified in my view.
Sorry my voice recognition software is not 100% percent reliable. the last part of the last quote should read: “but averages so broad” not “that average is so broad.”
For those that might be interested, one of my ideal models for recovery was the poets Coleridge and Southey’s plan to found a community on the banks of the Susquehanna in the 1790s (not too far from Laurance and Claire I think) based on the principles of ‘Pantisocracy’, that is the principle of government by all equally. Everyone was to have been equal, men, women, people of all origins, and all at the same time both personally free and mutually responsible. Partly because of Coleridge’s ‘unmanageability’ (he was later to develop a lifelong and very serious laudanum addiction) they never got it together.
Hello, again, Tim. The following is what I took exception to initially with your blog, and continue to be troubled by:
“I have seen various examples, some of which clearly originate in a kind of online manifesto published by someone who calls himself (or herself) Agent Orange. The so-called “Orange Papers” are in parts intelligent and cogent critique of the more egregious absurdities in the 12 Step literature, but the way in which the author uses so-called research evidence is extremely dubious, and despite academic-looking references, the inferences and conclusions drawn are either illegitimate or irrelevant to the current situation.”
Your use of dismissive phrases, such as “online manifesto”, “someone who calls himself”, “so-called research evidence”, “dubious”, “academic-looking references”, “either illegitimate or irrelevant” are, as I said, troubling. I have corresponded with Terry Hodgins, the author of the site, for several years, and have always found him to be extremely receptive to corrections of fact and constructive criticism. If you find legitimate fault with his research or his conclusions, by all means, engage him with it. I do, regularly. With about fifty thousand visitors/month from all over the world (except China, where he is blocked), he strives for accuracy and truthfulness.
As for pantisocracy, as you described it, I believe its primary flaw, which makes it unworkable, is that all are not equally equipped, or inclined, to govern. When everyone is in charge, nothing gets done.
My CyberBuddy Mikeblamedenial writes, “As for pantisocracy, as you described it, I believe its primary flaw, which makes it unworkable, is that all are not equally equipped, or inclined, to govern. When everyone is in charge, nothing gets done.”
Watching things happening in AA, I observed that if everyone is in charge and nothing is being done, there are controllers and power trippers who will step in and fill the void. I saw it happening over and over.
In some cases the big frogs in the small pond were nice frogs. I have happy memories of a number of meetings. But there were others who were big fat toads, favoring their pals and treating others like dirt, enjoying their power in the rooms.
Tim writes, “What attracted me to the 12 Step recovery movement as I experienced it was indeed its explicit insistence on egalitarianism, freedom of belief, autonomy of local fellowships etc…”
To me, this is another example of AA’s not being what it claims to be.
I found the “egalitarianism” dubious. I experienced heavy pressure to conform and present myself as being just like everyone else. I felt a pull, how shall I describe it? downward to the lowest common denominator. I felt pressured to see myself as no different from the “worst drunk” in the room. AA members sneer, “Oh, you think you’re Terminally Unique!” at anyone who doesn’t try to be just like everyone else. I’d watch people, mostly the guys, competing to see who was the “worst drunk”. Who was the most violent, the most destructive, who had done the most damage, oooh, he’s the worst drunk!
And please! please! don’t tell me that we have freedom of belief!
I had the freedom to play word games. I had the freedom to give my higher power any name I wanted and dress it up in any form I wanted, as long as I nevertheless believed that it was outside myself and would remove my character defects upon demand. I could describe my higher power in any terms I wished as long as I believed I could turn my will and my life over to it, and that in return it would remove my desire to drink one day at a time. It could be a tree or a doorknob or Group Of Drunks as long as I prayed and meditated and sought conscious contact with it in order to do its will and not my own.
But I was not free to disbelieve! I was not free to not have any “higher power”! Those people are vicious to non-believers. If you want to be a token atheist in AA, you have to play word games and play the Powerlessness Game.
(Yes, I did go through a period during which I was seriously out of control and powerless. I don’t deny that. But AA taught me to treat “Powerlessness” as if it were some sort of religious condition akin to Original Sin, and something I will never get over; and that I need “higher power” to do what I am perpetually unable to do myself. AA gave me no room to eventually develop my own power.)
As I write to you, I’m remembering how it was. We spent a considerable part of time in meetings telling each other what AA is. It’s an Honest Program, it’s Spirituality, not Religion, and it’s Attraction, not Promotion. We affirmed all this, and reaffirmed this, and told ourselves these things again and again.
And yes, we told ourselves that AA is egalitarian and that we have freedom of belief. We told ourselves those things until we believed them and could not see what was really happening. Part of the reason I left was the ignorance and blindness to reality. The ignorance seemed almost willful to me. It seemed that we learned to cultivate this utter blindness. I finally got to where I couldn’t deal with it any more.
Thanks to all for the discussion. I agree with both Tim and Laurance.
Tim wrote, “What attracted me to the 12 Step recovery movement as I experienced it was indeed its explicit insistence on egalitarianism, freedom of belief, autonomy of local fellowships etc…”
Tim, thank you, I couldn’t agree more. It was unbelievably wonderful, I thought finally a path was offered that enabled all the things I was seeking. But as Laurance points out, it was an illusion. It took three years before some doubts arose, and then many months before I could accept the truth behind AA, the truth that was intentionally and aggressively subverted by AA members.
In the end it became horrible, how could I continue after more was revealed? I felt completely violated, used and abused, like so many others. In fact for me, breaking free of AA became the wonderful freedom and self actualization, and self determination (i.e. responsible individual) that we all seek and is needed to become a whole person. I believe the ideals of AA (of course not at all unique to AA) live on with me, but the process and implementation of AA had to be discarded.
Roland
Hi everyone, this will be my last entry on this particular blog, although I do expect to continue some of the discussions on other threads.
I have learned a lot from this experience (my first on-line discussion really). I have been impressed by the vivid and detailed descriptions of other people’s experiences, which I take at face value, and to be honest if I had witnessed or been subjected to such things myself (anyone being vicious to me or anyone else) I too would have left and as soon as possible.
As I have said more than once I do believe that on the whole it is relatively safe and quite likely to be helpful (for most people seriously considering abstinence) to explore 12 Step recovery in the UK. I do think it is necessary for professionals to be active in helping vulnerable people to have a safe experience, and I completely agree that people need real choices.
I am currently reading ‘Empowering Your Sober Self’ by Nicholaus and am really enjoying it. In fact the descriptions of LifeRing support groups sound very much like my experience in NA and the philosophical differences between LifeRing and AA as he lays them out would easily have been accommodated in the NA groups I knew. I will write what I expect to be a very positive review of the book and post it here. I will be incorporating information about LifeRing and SMART recovery explicitly into my degree courses (they are already mentioned together with WfS and Methadone Anonymous, but I would like people who have experience of these resources to come and lead a class).
I have learned that if you try to be ‘ecumenical’ or take a middle position you are quite likely to be ‘shot by both sides’ as Howard DeVoto and Pete Shelley had it.
A couple of personal responses: Mike I do not intend to make insinuations and I have tried to make clear that I don’t like that type of thing. So, I regret using the term ‘so-called’. In Europe the word ‘manifesto’ is not pejorative – all the political parties publish one every election time. I agree that Orange’s site is an analysis as well, and I accept he wants to be accurate and honest, but the site clearly has a programme and his language is not exactly value neutral, which again is not a criticism in any way. My opinions about the relevance or legitimacy of any research findings or interpretations thereof are exactly that, opinions. By the way I did email him a couple of times and received no reply. I did not take this personally as I see he receives a very large quantity of correspondence.
Laura I really did value hearing your experience and I do understand why it was not possible for you to continue in good faith with AA. I am not sure how anyone can be denied ‘freedom of belief’. I was told in treatment and since a lot of things which I thought then and still think are utter nonsense. It would not have been possible for me to believe them, so I didn’t. I do know that you are not really speaking of this, and that you experienced pressure, ridicule and contempt for your beliefs. I am grateful that I did not. It really does sound as though British NA is much much more tolerant and less fundamentalist than New York AA, even if some people do experience the British fellowship negatively.
Thanks also to Mack, Claire and Roland and indeed al the posters.
Finally, the NICE guidelines which guide National Health Service practice in England and Wales on Psychosocial Interventions for Adult Substance Misuse (published in 2008), which follow a Cochrane type methodology, say the following:
1.3.2 Self-help
1.3.2.1 Staff should routinely provide people who misuse drugs with information about self-help groups. These groups should normally be based on 12-step principles; for example, Narcotics Anonymous and Cocaine Anonymous.
1.3.2.2 If a person who misuses drugs has expressed an interest in attending a 12-step self-help group, staff should consider facilitating the person’s initial contact with the group, for example by making the appointment, arranging transport, accompanying him or her to the first session and dealing with any concerns.
As a member of the Guideline Development Group I am partly responsible for these recommendations. What I am not responsible for is the sentence:
“These groups should normally be based on 12-step principles; for example, Narcotics Anonymous and Cocaine Anonymous.”
This statement is entailed by the methodology, as these groups are currently the only ones with RCT evidence to support their outcomes. The full guideline will tell you more about this evidence. A cautionary note is that these guidelines were only considering drugs other than alcohol, and studies about alcohol dependence were excluded as they fell outside the remit of the guidelines. NICE will eventually publish alcohol guidance but I don’t know when. I hope to see the day when there are studies about SMART and LifeRing that can be included in future systematic reviews.
Goodbye and see you on other blogs, I hope.
Tim
Oh yeah, one more thing. If everyone (or no-one) is in charge, nothing gets done. Tell that to Tim Berners-Lee (the founder of the World Wide-Web). Pantisocracy, which I agree is idealistic, is not government by everyone, it is government on the principle of everyone being equal (panto- = all, iso- = the same or equal, -cracy = rule or government).
Cheerio!
Back from holiday and reading through this thread. This is fascinating stuff that will take me some time to absorb. First thoughts and the themes that jump out for me are:
1) “Recovery” as an idea is a very new concept to people with susbtance misuse disorders in many parts of the North West of England.
2) Recovery is happening in communities. That is, it is a communal thing embracing families and communities.
3) Recovery is showing people still suffering that there is hope of a better future, independence and citizenship.
4) 12 Step Mutual Aid is currently at the heart of most recovery communities but SMART, Intuitive etc, etc are growing alongside as other recovery options.
5) If you were on the Titanic you wouldnt be that concerned whose lifeboat you got on as long as you got on one.
Hey Mark! Hope you had a good break!
Sorry I have to add one more thing. I mentioned somewhere above that I had read somewhere that a critic of 12 Steps had said that NA is more respectful and receptive to atheists, and that I personally hadn’t experienced any problems, in fact my views were quite commonly shared. Well I just found the page again at:
http://www.positiveatheism.org/rw/naway99.htm
I find it quite striking that Cliff Walker, a man extremely critical of and opposed to the 12 Step philosophy and concepts, should have commented so clearly about the differences he saw in the two fellowships. He is speaking about the American fellowships and the approved literature. This page kind of shows something of what I meant. Things can evolve and change. AA could become more like NA in this regard (and it may already be in many places), or vice versa, but recovery doesn’t have to be clamped in a doctrinal vice.
Mark writes, “1) “Recovery” as an idea is a very new concept to people with susbtance misuse disorders in many parts of the North West of England.”
What do we mean by “recovery”?
People have been maturing out of “alcoholism” and drug abuse without ever getting involved with AA or rehabs. When I quit smoking back in 1982 (and tobacco/nicotine is plenty addictive) I did so without being in a recovery group, nor did I think of myself as being “in recovery”.
It seems to me that being “in recovery” involves taking on an identity and an ideology. I remember being in AA and so caught up in being “an alcoholic” even though I had no desire to drink any more. Instead of moving on and no longer thinking about it, as is the case with smoking for me, I kept focusing on alcohol alcohol alcohol, long after it was history.
I have my doubts about “recovery”, and whether it is good for people to have this concept of “recovery”. I’m not saying it’s not good to stop the destructive drinking; rather I’m saying that I don’t know how healthy or useful it is to be “in recovery” and taking on the identity of a “recovering alcoholic” or “recovering drug addict”.
I’ve never been a “recovering smoker”. I’m someone who stopped smoking.
Mark concludes, “5) If you were on the Titanic you wouldnt be that concerned whose lifeboat you got on as long as you got on one.”
I don’t know that this is a good analogy. You’re not on a sinking ship. And wereas it might not make a difference whose lifeboat you get on when the ship is sinking, it does indeed make a difference what sorts of people you end up associating with.
I learned how to be “an alcoholic” at AA. I’d been an unhappy person in a bad marriage who drank quietly at home. I came to AA and learned that it’s funny and cool to be a wife-beater, to get violent in bars and get into fights and smash things up, to be a con artist and exploit people – it was not a good place to be. I would have been better off if I had not gone to AA and associated with those people.
Reading this thread about whether ‘to AA or not to AA’ encourages me to recognise my ambivalence, or rather the complexities of my feelings about the AA world. I started working last year at a 12 step based rehab where I found most of the professionals were ‘in recovery’ although not all in AA. I need to come clean here and admit that I am not an addict. I don’t know why. I have worked at it on occasion to deal with other problems which I do see myself in recovery from. (In that I have had to challenge denial, accept powerlessness, make amends and essentially work through the 12 steps.) It seems to me that I have been protected from addiction not by any personality traits but by a physiological trait. I have a remarkably low tolerance to any substance licit or illicit and tend to vomit or fall asleep with great ease! My life has become unmanageable at times, sometimes through my own choices and sometimes through others and I have known despair.(Rock bottom? I don’t know)
I felt rather embarrassed to admit my lack of addiction to some of my colleagues as there was certainly a sense of my not being a fully paid up member of the club. Can I understand addiction and can I offer useful support/therapy to those in addiction? I can understand being human and being in pain. Some of my personal life experiences help with understanding but if I had to have experienced everything that my clients have experienced to be able to work with them I would be too much of a mess to work at all. I understand the experience of others by putting aside my expectations, assumptions and prejudices and by carefully and sensitively listening and checking back that what I think I have heard is what has been said. I have practiced this over several years and have made use of training and reflection to help me hone these skills. I have learnt a lot from my clients and have wanted to. I aim to bring into any therapeutic relationship genuine care and genuine curiosity.
Perhaps there is a hint here of why AA can be a double edged sword. The strength of AA is its simple doctrine. It is directive and dogmatic and for someone lost in chaos, that is great. ‘Don’t try and work out what, how, why this thing is happening. Accept it and follow these rules and you will recover.’ For the person who is open to hear this and willing to be plugged into AA support, here is the life raft that will save them from drowning. For many people it is a life saver, but not for everyone. Nothing, no form of therapy, no medication works for everyone. It seems to me that there is a denial in AA of that simple truth. Some people can get sober without AA and some people cannot get sober with AA. There is ample evidence of this.
It is the denial of this in AA circles that gives it its religious quality. Asking a devout Muslim if perhaps actually being a Catholic is an equally good way of knowing God and achieving salvation is unlikely to receive a positive response. (Or vice versa, asking a Catholic). If I had found my salvation in AA, if I had come back from the brink of death by embracing the 12 step philosophy it would, or could, challenge my very sense of being to be able to say to someone else struggling with addiction, ‘I can see that you need an alternative to AA because it is not working for you.’. It could even be very difficult to consider new evidence or research that brought into question some of the AA dogma. Sad to say, I have experienced this in some work colleagues. I have also experienced massive blind prejudice in work colleagues on the other side of the fence who do not and will not work with a recovery model.
I am of the opinion that the simplicity, clarity and dogma of AA are both its strengths and its weaknesses. I have talked about the AA/12 step/abstinence/recovery/ harm reduction debate before in an article I wrote for Druglink Jan/Feb 2009 ‘Beth Vader’ and I guess there is even more in there of my attempts to make sense of it all.(I don’t know if it is okay to reproduce that on this website, perhaps David can advise.) What is essential is that all views and experiences are acknowledged and heard because what is certain is that addiction can kill and frequently creates misery for the addict and those around them. It is also very clear that more and more effective treatment and support is needed.
Thanks for listening.
Lisbeth
Would love you to reproduce article. I am away until next Sat but could set up as article when i return.
Hi
I like most of what Laurance has posted here and I agree with him that the AA Ideology is full of derogatory statements about Secular people and their lifestyle. I do not think that there is one positive statement in the original Big Book material and the 12×12 about Secular People.
I find it strange that debaters who reply to questions about AA’s stance on secular people immediately skip to the “God Talk” in AA Foundations instead of answering why is there need for the hate message toward Secular people in AA Ideology.
William
I would like to know the difference between 12 step recovery and 12 step treatment?
what are the 12 steps of treatment..?
i know the 12 steps of recovery .
