The Irrationality of Alcoholics Anonymous

[afc wimbledon]

Originally Posted by PsYcNeT

Invalid means it's no longer useful. I read that as "useful to some people, in some cases, but better options are available".

The biggest complaint surrounds the fact that AA a) doesn't work for everyone, and b) it's the biggest, loudest and most visible player in town. A person who fails at AA is less likely to seek other avenues.

No one, in AA or out, has ever claimed it, or any other treatment works for everyone.

It's not in the least loud, in fact you'd be hard pressed to get a peep out of them about anything, their rules make it quite clear, no one at AA is allowed to comment on anything.
It's the biggest, but that's a function of it being voluntary, it is a charity, not a treatment program.

I would argue that the criticisms, all of which ungrounded, of AA are far more likely to put someone off seeking treatment. If you go to AA and struggle you will get tons of help applying for other treatments generally, there is no better place to connect with a recovery house or get advise on how to get into detox.

I have helped kids get involved in AA, alanon NA and CA (all who grew out of the AA program) over the years, I have never found them to be anything other than unfailingly helpful and well intentioned.
I would absolutely agree we need more choices out there, but to take a shot at AA because we don't want to pony up our taxes for anything else is again reprehensible.

You might as well argue all thrift stores are useless because you can't get a decent cashmere jacket in them.

[PsYcNeT]

Originally Posted by afc wimbledon

No one, in AA or out, has ever claimed it, or any other treatment works for everyone.

It's not in the least loud, in fact you'd be hard pressed to get a peep out of them about anything, their rules make it quite clear, no one at AA is allowed to comment on anything.
It's the biggest, but that's a function of it being voluntary, it is a charity, not a treatment program.

I would argue that the criticisms, all of which ungrounded, of AA are far more likely to put someone off seeking treatment. If you go to AA and struggle you will get tons of help applying for other treatments generally, there is no better place to connect with a recovery house or get advise on how to get into detox.

I have helped kids get involved in AA, alanon NA and CA (all who grew out of the AA program) over the years, I have never found them to be anything other than unfailingly helpful and well intentioned.
I would absolutely agree we need more choices out there, but to take a shot at AA because we don't want to pony up our taxes for anything else is again reprehensible.

You might as well argue all thrift stores are useless because you can't get a decent cashmere jacket in them.

Well the Salvation Army does have a lot of issues associated with it, but this isn't the thread for that.

I'm not sure why you are taking issue with the fact the AA is a fallible entity, or why some people are pointing that out. You even openly admitted that the abstinence and higher power stuff is weird.

EDIT: Reading back, it seems your whole argument is based about the fact that none of this is AA's fault. Even ignoring it's archaic and bizarre requirements for success, someone pointing out that there needs be more awareness of other avenues is just that, raising awareness of other avenues. If better avenues exist, why get up in arms about someone pointing this out?

[Bagor]

I am a recovering alcoholic. Been sober just over five years. I am also agnostic and from a scientific background. AA works for me.

I still attend AA meetings on a regular basis sitting at tables with ex crack whores on one side and lawyers and top doctors on another side. With people ranging from early 20s to their 90s. Don't ask me why but it works for me when nothing else would. And trust me, when you can't control your intake and obsess about it constantly it literally takes over and controls your life.

I mention that because I suppose it gives an insight that I might be a tad biased but ... I honestly didn't get the point of the article. In fact I find it a bit irresponsible in that I found it needless.

Originally Posted by Vulcan

This is my personal experience and if a program or something else works for you, stick to it.

To the article itself. I personally thought .. yes it was long, but well written? No. Some of her figures I thought were way out there, e.g. To suggest 12% of members are only there by court order is just plain stupid.

Anyways ...who cares if the success rate is in the single digits or even 1%? That's still success given it is after all a free program.

But researchers have debunked central tenets of AA doctrine and found dozens of other treatments more effective.

I can't find the dozens of more effective treatment part?

Anyways ... all I am saying AA and the twelve step program works for me and I find it sad to bash something that whilst not perfect, saves lives at no cost to the public.

[PsYcNeT]

Originally Posted by Bagor

Anyways ... all I am saying AA and the twelve step program works for me and I find it sad to bash something that whilst not perfect, saves lives at no cost to the public.

Again, anecdotal evidence aside, why is it sad to criticize something that is free?

Everything and everyone everywhere for all time should be a valid target for criticism if warranted. This should never be up for debate.

[Bagor]

Originally Posted by PsYcNeT

Again, anecdotal evidence aside, why is it sad to criticize something that is free?

Because somewhere there might be some poor fella reading this under the grip of alcoholism contemplating attending his first meeting.

It discourages open mindedness, one of the key components of the program.

Originally Posted by PsYcNeT

Everything and everyone everywhere for all time should be a valid target for criticism if warranted. This should never be up for debate.

Ok, fair enough. I just found it a really crap article truth be told.

Not a hope in hell would you get me risking my life by potentially deluding myself that I could take some pill that would enable me to drink normally.

[rubecube]

Originally Posted by Bagor

To the article itself. I personally thought .. yes it was long, but well written? No. Some of her figures I thought were way out there, e.g. To suggest 12% of members are only there by court order is just plain stupid.

Do you have numbers or sources that counter the claim?

Anyways ...who cares if the success rate is in the single digits or even 1%? That's still success given it is after all a free program.

Except that it's often offered as the only way, and even AA is complicit in this by saying things like:

Rarely have we seen a person fail who has thoroughly followed our path. Those who do not recover are people who cannot or will not completely give themselves to this simple program, usually men and women who are constitutionally incapable of being honest with themselves. There are such unfortunates. They are not at fault; they seem to have been born that way.

As the article mentions that's a pretty narrow and unhelpful view of addiction, that fails to account for other mitigating circumstances. Also, they're quite clearly making claims about alcoholism being a progressive disease, and that cold turkey is the only way to quit, and not backing these claims with any reputable, scientific evidence. You don't think that's somewhat problematic?

I can't find the dozens of more effective treatment part?

This was right in the article:

A meticulous analysis of treatments, published more than a decade ago in The Handbook of Alcoholism Treatment Approaches but still considered one of the most comprehensive comparisons, ranks AA 38th out of 48 methods. At the top of the list are brief interventions by a medical professional; motivational enhancement, a form of counseling that aims to help people see the need to change; and acamprosate, a drug that eases cravings. (An oft-cited 1996 study found 12-step facilitation—a form of individual therapy that aims to get the patient to attend AA meetings—as effective as cognitive behavioral therapy and motivational interviewing. But that study, called Project Match, was widely criticized for scientific failings, including the lack of a control group.)

Anyways ... all I am saying AA and the twelve step program works for me and I find it sad to bash something that whilst not perfect, saves lives at no cost to the public.

I don't think that writing an article disputing some of AA's claims and demonstrating that there are alternative forms of treatment constitutes bashing.

[rubecube]

Originally Posted by Bagor

Because somewhere there might be some poor fella reading this under the grip of alcoholism contemplating attending his first meeting.

It discourages open mindedness, one of the key components of the program.

Except in the same article it notes other forms of treatment, so wouldn't it actually be promoting open-mindedness by providing a variety of alternative treatments? Psychologically speaking, wouldn't it be better for the guy to know there are more treatments if AA doesn't work form him and that it's not necessarily his fault?

Ok, fair enough. I just found it a really crap article truth be told.

Not a hope in hell would you get me risking my life by potentially deluding myself that I could take some pill that would enable me to drink normally.

That's fine if you don't want to, but the science seems to be positive so the option should be available to others, and I don't understand what AA has to gain by being against it.

[PsYcNeT]

I think what we're seeing here is the same bias you see with parents discussing parenting.

Often, parents are quick to offend when people offer advice or anecdotes counter to what has worked for them. Most take it as a personal affront to their choices, without taking into account that every child is different.

It's literally the same thing here with people taking it as an affront to their choices, when the article is really just saying "What about the people it doesn't work for? Do they deserve to be classified as broken husks of humanity?"

[Bagor]

Originally Posted by rubecube

Do you have numbers or sources that counter the claim?

Personal observation. The forms have to be signed.
What does she base her numbers on?
There are an estimated 1.3M members of AA in N. America. Is she seriously suggesting that 160k of them are court orders?

Except that it's often offered as the only way,

Is it? I don't know.

Also, they're quite clearly making claims about alcoholism being a progressive disease, and that cold turkey is the only way to quit, and not backing these claims with any reputable, scientific evidence. You don't think that's somewhat problematic?

For me? No.
Looking back on it, my disease was progressive and I believe the only way I can manage it is total abstinence. I'm just speaking for myself here and my experiences.

This was right in the article:

I've gotta call BS on this one. But again that is based on personal experience. e.g. My sobriety is based on continuous abstinence. A brief intervention by a medical professional wasn't helping me, and quite frankly I have a hard time believing it would help many active alcoholics without some form of complimentary treatment.

Besides ...

Here and throughout the piece, Glaser is simply ignoring a decade’s worth of science....

Glaser is right to point out that it is foolish, if not harmful, to treat AA and 12-step programs as one-size-fits-all panaceas. They’re not. She’s also right to point out that other treatments, including promising pharmaceutical options, may not always get the attention they deserve. But untangling a problem as complex as addiction requires taking into account all the best, most recent research. Glaser didn’t do that, and as a result she and The Atlantic simply aren't giving readers an accurate view of the current addiction-research landscape.

http://nymag.com/scienceofus/2015/03...ous-works.html

Except in the same article it notes other forms of treatment, so wouldn't it actually be promoting open-mindedness by providing a variety of alternative treatments? Psychologically speaking, wouldn't it be better for the guy to know there are more treatments if AA doesn't work form him and that it's not necessarily his fault?

Sure, but you do agree that the article is a bit favoured towards some treatments as opposed to others. If she wants to promote openmindedness treat all with the same weight.

I don't understand what AA has to gain by being against it.

Are they? I don't know.

[Bagor]

Originally Posted by PsYcNeT

Often, parents are quick to offend when people offer advice or anecdotes counter to what has worked for them. Most take it as a personal affront to their choices, without taking into account that every child is different.

It's literally the same thing here with people taking it as an affront to their choices, when the article is really just saying "What about the people it doesn't work for? Do they deserve to be classified as broken husks of humanity?"

I'm not offended at all. Honestly.

Why would I be?

[PsYcNeT]

I don't know, but the fact that AA considers people unable to finish the program lesser humans offends me.

[rubecube]

Originally Posted by Bagor

For me? No.
Looking back on it, my disease was progressive and I believe the only way I can manage it is total abstinence. I'm just speaking for myself here and my experiences.

I've gotta call BS on this one. But again that is based on personal experience. e.g. My sobriety is based on continuous abstinence. A brief intervention by a medical professional wasn't helping me, and quite frankly I have a hard time believing it would help many active alcoholics without some form of complimentary treatment.

Okay, so you're calling B.S. on peer-reviewed studies because they don't align with your anecdotal experiences?

Besides ...

http://nymag.com/scienceofus/2015/03...ous-works.html

Sure, but you do agree that the article is a bit favoured towards some treatments as opposed to others. If she wants to promote openmindedness treat all with the same weight.

She's favouring the treatments that have stronger evidence supporting them. That's like expecting an editorial on immunity to treat anti-vaxxers with the same reverence as immunologists.

Are they? I don't know.

It's in the article as something AA generally advises against. It would also be pretty consistent with their 12-steps.

[PsYcNeT]

I always thought open mindedness was about giving every option or opinion a voice/consideration, not treating them with the same weight.

[afc wimbledon]

Originally Posted by PsYcNeT

I don't know, but the fact that AA considers people unable to finish the program lesser humans offends me.

AA doesn't consider anyone lesser, in fact the central tenant to AA is every alcoholic, whether they are drinking or sober, is the same.

It's actually one of the areas I think is a weakness in the program, although it brings comfort and strength to many, it's essentially the idea that 'you are not weak or an eff up, you are an alcoholic, just like everyone else in the room, no better or worse'.

In a wholly voluntary program with no leaders (in theory) or rank it's about the most accepting and egalitarian philosophy your ever likely to encounter.

You can also take offence at the vaguely religious nature of the program, but again, welcoming people back to try again, be it once or a thousand times is a central tenant of AA, I cannot think of any organization as un judgmental, you can turn up at a meeting half cut, reeking of piss and vomit and you will be taken in, coffeed up to hell and back and cheered for your first day sober.

[Bagor]

Originally Posted by PsYcNeT

I don't know, but the fact that AA considers people unable to finish the program lesser humans offends me.

What are you talking about?

Same question to you Rubecube. What are you basing this on?

Because quite frankly I can think of nothing further from the truth.

[PsYcNeT]

http://www.google.ca/url?sa=t&rct=j&...g1eaqjJbCfLibA

[afc wimbledon]

Originally Posted by PsYcNeT

http://www.google.ca/url?sa=t&rct=j&...g1eaqjJbCfLibA

I don't know any treatment program that doesn't require the addict to be honest first, it's an absolute tenant of one on one counselling, marital therapy, in this AA was groundbreaking and correct.

Bill, the founders, view of alcoholics that didn't stop drinking, that they were unfortunates, they are not at fault, not exactly judgemental, and I should point out that AA doesn't require you to agree with any of this, it asks that you follow the steps and come to the meetings, accept a sponcer that's it.

[Bagor]

And that offends you?
The very nature of the disease is dishonesty with self or the delusion that one can drink normally.

It's a simple fact for me. I need to be honest with myself everyday that I can't drink normally.

I stated I was five years sober. If I was to get drunk tomorrow it would be because of an inability to be honest and accept that I can't drink normally. I've got to be honest every day.

[Itse]

I really get a feeling that most people didn't actually read the article, at least not properly.

The main point of the criticism IMO is clearly not AA as an organization, but
1) The effectiveness of their 12 step program
2) The cultural dominance of AA in the way alcohol abuse is seen in the society and even by people who really should know better.

As things are, you have doctors that essentially refuse to give the patients the treatments that have the best track records in favour of one that is statistically much less likely to help, and judges forcing people to take a "treatment" that not only is statistically unlikely to help them, but actually has a pretty good chance of making their problem worse.

You also have shoddy facilities that charge ridiculous amounts of money, run by people who don't necessarily have any qualifications or training, selling treatments that mostly don't work.

These are all very real problems, and while it's true that it would be unfair to blame AA for all of it, it's also ridiculous to suggest that they have NO responsibility for the situation. So while the main point might not be on AA as such, there are still very good reasons to also criticize them direcly.

Besides, as by far the biggest and best known organization I would claim the AA has the moral obligation to give out information on the various treatments available for those whe come to seek help, not just the one they give. After all, the goal is not to have people find God, but to help them with their alcohol problem, and they are a non-profit organization so it should not be a problem for them. It's not like they pretend to be the best solution for everybody.


There's no reason the AA would need to abandon it's 12 step program completely in light of this kind of criticism. For example a combination of AA meetings AND medication would statistically be very likely to work better than just the meetings.

[Vulcan]

One thing that I find in this thread is that the ones who haven't been in a situation of substance abuse can speak theoretically about what works but for the people in this situation, it's a desperate situation. I found what worked for me but to overly criticize forms of treatment that work on a personal level in what could be a life or death situation, is a little out there. AA or NA has it's warts and what I do could be accused by the ignorant of being in a cult whereas taking drugs to control your addiction, as recommended in this article, maybe worse than the ailment. Myself I don't like that idea as there are usually side effects from any drug and it's getting a little too easy to prescribe a drug for whatever mental problem we encounter but if that is what works for you, go for it.