I stopped drinking 30 years before this article was published. A 12 step program played a big part in it. Since then I have been an amateur student of the field, and I feel these gentlemen are more wrong than right. AA is an easy target because when you read the text there is a lot of BS in it---But the organization created by it does work better than anything before it, and most things since. I am not sure if the record is 5% or 30% or whatever, but it is surely more than zero. One of the best defenses AAs methods I have seen is the opinion of Charlie Munger, who talks about how AA uses several common human tendencies that are hardwired into most of us all at the same time in a synergistic way.
With Sobering Science, Doctor Debunks 12-Step Recovery (2014)
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Re: With Sobering Science, Doctor Debunks 12-Step Recovery (2014)
#72Earlier quoted context omitted.
> The problem is when we make decisions for other people. Things look very, very different, when it's our own butt on the line. Which is precisely what this article is complaining about. AA both as a program and as cultural push "abstinence first" is harming addicts for which the AA method is not successful. Which is most people. For instance drug therapies are slow to be given approval, people are sent to AA program…
What is more effective than AA?
If you are looking at raw numbers, lots of things. MAT (Medically Assisted Treatment) is considered more effective, numbers-wise. There's a huge amount of money being made in the field.
Also, AA and NA don't collect much, in the way of data. It's actually hard to tell how truly effective they are. Something to do with the second "A," I would guess...
That brings up another point that people have been avoiding, here: Desperate people can be squeezed hard. A lot of folks are making a lot of money, from people with their lives in tatters.
Some of the therapies are effective, but a lot of them are definitely not.
Since people like to cast addiction (and alcoholism is simply addiction to the sedative-hypnotic drug ethyl alcohol) as a moral failing on the part of the addict, it's easy to blame them, and say that "they got what they deserved."
It's really pretty hard to feel sorry for many addicts. Pick up the paper, on any given day, and you'll likely see some horrific stories of crimes committed by addicts.
That's why programs like AA and NA work. The only people that actually care about addicts, are other addicts. It's also important that they not be in a position to profit from their treatment. 12-Step programs live on a regimen of enforced poverty. They love to fight about money, but the amounts are chicken feed, compared to what the for-profit orgs make.
Which begs the question: If someone makes money by selling treatment to desperate, ostracized, people, is it surprising that they don't like organizations that provide highly effective treatment for free?
Re: With Sobering Science, Doctor Debunks 12-Step Recovery (2014)
#73Earlier quoted context omitted.
but 4) 5) 6) are exactly blaming yourself. Indeed, they seem to focus on the bad things you have done (to others) as a result of your addiction, but with nothing about the cause of the addiction itself. Agree with step 1) - and 2) in many cases - but perhaps 3) should be about figuring out what's been behind it and trying to remove that stressor. And then maybe another step can consider the disease paradigm, as a sel…
> 4 - List all the complaints people have about you and analyze what you might be doing wrong That's not blaming yourself for alcoholism, which I think is the point your missing. > 5 - Share your failings, no matter how embarrassing, with a trusted other on the principle that confession is good for the soul and sunlight is the best disinfectant Again, this isn't about blaming yourself for your alcoholism AT ALL. This…
You may not be blaming yourself for the addiction itself, but certainly you are blaming yourself (i.e. deciding that you are the problem and you need to change) for your actions under the addiction.
I suspect for many that fine distinction would be lost, and it would be easy to fall into thinking that this is all my fault (and that I could do with a drink to get over it).
Perhaps one of the steps should be to separate the causes of the addiction, from the effects of the addiction. Then it becomes much easier to come to terms with what you have done, as you can separate things that you had a choice over, vs things you did not.
Of course I am taking the (modernist?) approach of 'to understand something is to control something'. Maybe that won't work for everyone, but I'd like to think it would work for many.
Re: With Sobering Science, Doctor Debunks 12-Step Recovery (2014)
#74Earlier quoted context omitted.
> 4 - List all the complaints people have about you and analyze what you might be doing wrong That's not blaming yourself for alcoholism, which I think is the point your missing. > 5 - Share your failings, no matter how embarrassing, with a trusted other on the principle that confession is good for the soul and sunlight is the best disinfectant Again, this isn't about blaming yourself for your alcoholism AT ALL. This…
You may not be blaming yourself for the addiction itself, but certainly you are blaming yourself (i.e. deciding that you are the problem and you need to change) for your actions under the addiction. I suspect for many that fine distinction would be lost, and it would be easy to fall into thinking that this is all my fault (and that I could do with a drink to get over it). Perhaps one of the steps should be to separat…
> Of course I am taking the (modernist?) approach of 'to understand something is to control something'.
This makes me think of the serenity prayer, which is such a huge part of AA -- and very much encouraging finding those important distinctions.
> grant me the serenity to accept the things I cannot change, courage to change the things I can, and wisdom to know the difference.
Re: With Sobering Science, Doctor Debunks 12-Step Recovery (2014)
#75Earlier quoted context omitted.
You can edit your posts within an hour or so. Look for the " edit [–]" up there to the right of your username, just before the title. EDIT: or "edit | delete [–]", as the case may be.
Interesting, can edit with hours gone by but not delete. Ah well, the inevitable next time. Thanks for the tip.
Yeah, I should have replied to your original message so that you could delete the follow-up. As sibling comment points out, you can't delete once someone replies to your message. I knew better, I just didn't think it all the way through. Anyway, now you know.
Re: With Sobering Science, Doctor Debunks 12-Step Recovery (2014)
#76Earlier quoted context omitted.
I think that's one of the practical problems both with AA itself and with criticisms of it. It occupies this space in the cultural milieu as the main or even only system to address alcoholism. You have judges sending drunk drivers & domestic abusers to AA and shit, atheists in there freaking out needing help they're not gonna get because they didn't know what they were getting into and the steps very clearly are not…
> exhausting, endless, and humiliating. That is part of why it works for those it works for, but if you can find another way you'll have a better time. I see what you did, there. I think the word you are looking for is "humbling." Completely different animal from "humiliating." It's not "exhausting," either. Not sure where that came from. > you'll have a better time. Not sure I'd find agreement with that statement. L…
Of all the places I comment online this is the only one where I'm routinely told I meant to say something other than what I said. I used to think I was just an unclear writer but it continues to only happen on HN.
Anyway I'm not anti-AA, I've been in it for years and am happy with it. I've also engaged extensively with what I perceive to be its limitations and constraints. I said what I meant to say and I meant what I said.
I meant humiliating. There are recovery programs that emphasize your courage and strength in confronting a highly stigmatized mental illness, that encourage reflection on the routine frailty of the human mind, its susceptibility to this sort of failure, the capriciousness of who falls into addiction and who doesn't. Does that sound like AA to you? AA encourages you to think of yourself as permanently faulty in an irreparable way and to choose your actions with that fault in mind. This is rather practical in preventing relapse, but it's not a resounding message of self-actualization.
The "confession of sins" in steps 5, 8, 9 are inevitably going to be experienced as shameful and yes, humiliating. This is effective! It's a powerful deterrent to that behavior in the future.
I meant exhausting. There is never a point in AA where you are cured, where you are free of AA, free of the burden of thinking of yourself as an alcoholic. Again this is very pragmatic: it reminds you that readdiction is always possible, it keeps you from letting your guard down even years into recovery. It also means the vigilance is eternal, exhausting.
Everyone who has grappled with addiction agrees that sobriety is a better way of life. But that doesn't mean AA is the only way to get to it, or the most pleasant among the options. "We thought we could find an easier, softer way." We could not, but some others can, and those who can will have an easier, softer time than we do in here.
Re: With Sobering Science, Doctor Debunks 12-Step Recovery (2014)
#77Earlier quoted context omitted.
>... and bury the fact that the majority of the shooters are on SSRI's and a host of other medication. Can you please cite a source for this? >It's because when you peek behind the curtain, you find they're just a form of culturally acceptable medicine men. "Here, take these pills and it will solve all your issues! No we don't have any idea what 'chemical imbalance' is happening, or even if it's happening, but that's…
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Re: With Sobering Science, Doctor Debunks 12-Step Recovery (2014)
#78Earlier quoted context omitted.
> exhausting, endless, and humiliating. That is part of why it works for those it works for, but if you can find another way you'll have a better time. I see what you did, there. I think the word you are looking for is "humbling." Completely different animal from "humiliating." It's not "exhausting," either. Not sure where that came from. > you'll have a better time. Not sure I'd find agreement with that statement. L…
Of all the places I comment online this is the only one where I'm routinely told I meant to say something other than what I said. I used to think I was just an unclear writer but it continues to only happen on HN. Anyway I'm not anti-AA, I've been in it for years and am happy with it. I've also engaged extensively with what I perceive to be its limitations and constraints. I said what I meant to say and I meant what…
My apologies, then. I do understand your point. I may have a bit to say, but you know, that ol' Tradition Eleven, and whatnot. Just be aware that there are others, on their own journeys.
I found that using was exhausting. I don't think that having addiction under control, is exhausting at all. Others have far worse crosses to bear, and all the good things that have come, have more than made up for any issues that I may have, as a result of a .44 magnum, pointed at my head, all the time. It's definitely "endless," but so are many things.
I've found that the Fourth, Fifth, Sixth, Seventh, Eighth, Ninth, and Tenth Steps are about losing the shame of of active addiction. In fact, their most practical use, is to have us become so comfortable with our pasts, that we can routinely recount them, to people looking for help. What It Was Like, What Happened, and What It's Like, Now.
That "What it Was Like" part is real important. If we're not comfortable telling some shaking newcomer that we used to rob church poorboxes, then we're kinda useless.
But what do I know? I'm just some Internet rando. I wouldn't have even written this, if this story hadn't been shoved to the back of the broom closet in record time.
Have a great day.
Re: With Sobering Science, Doctor Debunks 12-Step Recovery (2014)
#79Earlier quoted context omitted.
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…
> Another form allows participants to drink but uses a medicine which induces unpleasant effects from alcohol. Actually, the successful medical method doesn't introduce unpleasant effects, but removes the pleasant ones and introduces 'extinction'. The medication is naltraxone. Look up 'Sinclair method'.
> To avoid strong side effects such as nausea and vomiting, practitioners typically wait until after the alcohol detox process before administering naltrexone.
If you take one or two drinks, yeah it will just be not good. If you binge, you be puking your guts out.
Re: With Sobering Science, Doctor Debunks 12-Step Recovery (2014)
#80Earlier quoted context omitted.
What is more effective than AA?
If you are looking at raw numbers, lots of things. MAT (Medically Assisted Treatment) is considered more effective, numbers-wise. There's a huge amount of money being made in the field. Also, AA and NA don't collect much, in the way of data. It's actually hard to tell how truly effective they are. Something to do with the second "A," I would guess... That brings up another point that people have been avoiding, here:…
The fight I witnessed because someone bought the "expensive" Bic pens instead of the 1c/pen less expensive.