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With Sobering Science, Doctor Debunks 12-Step Recovery (2014)

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Re: With Sobering Science, Doctor Debunks 12-Step Recovery (2014)

#21

Post by rootusrootus »

JamesBarney wrote: post #15
phs318u wrote: post #2

Sigh. As someone who’s had success in 12-step recovery since 1998, I find these sorts of “debunkings” incredibly disappointing. Firstly the measurement of success rate entirely misses the point. The 12-step view is that there isn’t a “once and done” cure. If I were to use an analogy it’s more like having lifelong diabetes. You gotta keep taking that insulin. It’s the continuity that forestalls the disease/ keeps you…

Yeah one of the issues is that much of the 12-step recovery community does not condone alcohol abuse disorder medication. So to extend your analogy it would be like a community that focuses exclusively on curing diabetes through a ketogenic diet, but also tells people they shouldn't take their insulin. Maybe ketogenic diet works, but we do need good data to figure out how it compares to taking insulin.

I think GP was talking about type 1 diabetes, which is an entirely different disease than type 2, and certainly not treatable with diet.

Re: With Sobering Science, Doctor Debunks 12-Step Recovery (2014)

#22

Post by lo_zamoyski »

I don't know much about AA, but whatever the case may be, I wonder if measuring effectiveness based on success rate numbers is all that meaningful. That is, does it makes sense to view it in medical terms? While it seems to be the case that some are more prone to alcoholism than others based on genetic factors, whether one actually becomes an alcoholic is not a matter of deterministic factors like a disease might be. There is a huge component of assent. Thus, it is related to character, virtue, and habit. Temperance is, at bottom, a matter of "orderliness" (vs. disorder) of the faculties and appetites moderated and ruled over by reason and a will that conforms to the truth as known by reason. This entails restraint, moderation, self-denial, and the ability to suffer well when illicit desires surface, such as the desire for a drink when you know, rationally, that you ought not drink, that it is harmful and wrong to do so. Indeed, for all of us, to be able to suffer is essential to being a good human being; those who cannot suffer cannot live well and cannot love well. Practices of self-denial, like fasting, and self-sacrifice help cultivate this self-mastery. Sacrifice is always that of the lower for the sake of the higher.

My point: perhaps success rates are to be understood also in light of personal commitment, understanding, and what makes commitment possible. Most people struggle with bad habits and addictions of all sorts and sizes. Alcoholism is just one of them and one that happens to be conspicuously destructive. Perhaps the "success rates" for the others are comparable because most people simply prefer to keep the bad habits and avoid (or lack the basic knowledge of the need for) the suffering they must endure to be made free of such things. Why assume alcoholics and alcoholism are any different than most people and most habits, mutatis mutandis?

Re: With Sobering Science, Doctor Debunks 12-Step Recovery (2014)

#24

Post by gray5 »

phs318u wrote: post #2

Sigh. As someone who’s had success in 12-step recovery since 1998, I find these sorts of “debunkings” incredibly disappointing. Firstly the measurement of success rate entirely misses the point. The 12-step view is that there isn’t a “once and done” cure. If I were to use an analogy it’s more like having lifelong diabetes. You gotta keep taking that insulin. It’s the continuity that forestalls the disease/ keeps you…

[flagged]

Re: With Sobering Science, Doctor Debunks 12-Step Recovery (2014)

#25

Post by ChrisMarshallNY »

phs318u wrote: post #2

Sigh. As someone who’s had success in 12-step recovery since 1998, I find these sorts of “debunkings” incredibly disappointing. Firstly the measurement of success rate entirely misses the point. The 12-step view is that there isn’t a “once and done” cure. If I were to use an analogy it’s more like having lifelong diabetes. You gotta keep taking that insulin. It’s the continuity that forestalls the disease/ keeps you…

Yeah...been hearing this stuff for 42 years. I could probably make an entirely convincing argument as to why you shouldn't try it. That's because I've heard it all.

If you don't want what we have ... no worries. You won't get it.

The problem is when we make decisions for other people. Things look very, very different, when it's our own butt on the line.

Re: With Sobering Science, Doctor Debunks 12-Step Recovery (2014)

#26

Post by vorpalhex »

specproc wrote: post #19
phs318u wrote: post #13

Earlier quoted context omitted.

Identifying as an alcoholic or gambling addict or drug addict etc, is no different than saying "I'm a diabetic". It's the label of a chronic disease. Applying that label to self is about acceptance of that as a fact of life that you can then work with. If you've ever been unfortunate enough to see e.g. a diabetic who did not accept the reality of their illness - it's not pretty. Acceptance is the price of vigilance.…

People can choose to identify as they wish, and I'm not for one second diminishing that identification. But problematic drinking is very different to diabetes, it's also highly varied in its expression and not as deterministic as the label suggests. I totally understand why it's a helpful framing for some people, but it really isn't for others.

To extend this, there have been programs that have attempted to fix the problems of alcohol addiction but not require patients to remain sober. The core concept being that there is an underlying cause to the alcohol problem and the alcoholism is an expression of that problem, not itself a root. Thus once the root cause is fixed, the alcohol is no longer a trigger.

Another form allows participants to drink but uses a medicine which induces unpleasant effects from alcohol. Thus participants self train an avoidance pattern and break the positive feedback loop.

These should not be seen as contrary to the AA abstinance approach. For some people that appears to be the most effective means. For many other people, AA is not.

I suspect as we advance our understanding we'll come to find distinct subdiagnoses in alcoholism and alcohol abuse that suggest different treatment strategies. Right now our understanding feels very rudimentary.

Re: With Sobering Science, Doctor Debunks 12-Step Recovery (2014)

#28

Post by boplicity »

labrador wrote: post #3

I'm a recovering alcoholic who has worked the 12 steps. To get this out the way, I agree that courts should not be sending people to AA. It's no good for anyone. The reason that the 5 to 10 percent do well in AA actually doesn't have to do with the 12 steps themselves; it has to do with the camaraderie. I agree with the second half of the that sentence, but the reason the reason many people including researchers don'…

The interesting thing about the 12 steps is that, really, they're what many, many people do anyways.

Basically, they can be summed up as "take responsibility, get help when you need it, and help others when you can." This is what most emotionally mature adults do anyways.

Unfortunately, the disease of alcoholism can lead people quite far from this type of otherwise normal behavior. (And not just for the drinkers!)

I wish there was far more education in North America about alcoholism, especially for teenagers and pre-teens. Considering the epidimic level of damage being inflicted by the disease, I don't think it would be unreasonable to have required classes in middle school or high school on the topic.

Re: With Sobering Science, Doctor Debunks 12-Step Recovery (2014)

#29

Post by pookha »

I remember reading a William Burroughs interview where he talked about getting over nasty addictions by just writing "I will not smoke a cigarette" on a piece of paper everyday. This stupid process worked incredibly well for me. Broke a bad smoking habit. Anytime I felt the urge I'd re-write the statement. I could see how the same thing could work with drinking if and when you get triggered (grilling in the backyard, restaurant, etc).

Re: With Sobering Science, Doctor Debunks 12-Step Recovery (2014)

#30

Post by ChrisMarshallNY »

labrador wrote: post #3

I'm a recovering alcoholic who has worked the 12 steps. To get this out the way, I agree that courts should not be sending people to AA. It's no good for anyone. The reason that the 5 to 10 percent do well in AA actually doesn't have to do with the 12 steps themselves; it has to do with the camaraderie. I agree with the second half of the that sentence, but the reason the reason many people including researchers don'…

I like that breakdown.

Stealing it...

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