Wired examines the neuroscience of Alcoholics Anonymous

In this month's Wired Magazine, Brendan Koerner takes a look at the neuroscience behind Alcoholics Anonymous— and the neuroscience of alcoholism. More than a million people belong to AA. The "peer to peer" recovery system has been in existence for more than 75 years, founded during the Great Depression by a drunk stockbroker.

How does it work? Nobody really knows. *

As for the steps themselves, there is evidence that the act of public confession--enshrined in the fifth step--plays an especially crucial role in the recovery process. When AA members stand up and share their emotionally searing tales of lost weekends, ruined relationships, and other liquor-fueled low points, they develop new levels of self-awareness. And that process may help reinvigorate the prefrontal cortex, a part of the brain that is gravely weakened by alcohol abuse.
To understand the prefrontal cortex's role in both addiction and recovery, you first need to understand how alcohol affects the brain. Booze works its magic in an area called the mesolimbic pathway--the reward system. When we experience something pleasurable, like a fine meal or good sex, this pathway squirts out dopamine, a neurotransmitter that creates a feeling of bliss. This is how we learn to pursue behaviors that benefit us, our families, and our species.
When alcohol hits the mesolimbic pathway, it triggers the rapid release of dopamine, thereby creating a pleasurable high. For most people, that buzz simply isn't momentous enough to become the focal point of their lives. Or if it is, they are able to control their desire to chase it with reckless abandon. But others aren't so fortunate: Whether by virtue of genes that make them unusually sensitive to dopamine's effects, or circumstances that lead them to seek chemical solace, they cannot resist the siren call of booze.

Secret of AA: After 75 Years, We Don't Know How It Works

* Just keep coming back, because it does work.

Boing Boing editor/partner and tech culture journalist Xeni Jardin hosts and produces Boing Boing's in-flight TV channel on Virgin America airlines (#10 on the dial), and writes about living with breast cancer. Diagnosed in 2011. @xeni on Twitter. email: xeni@boingboing.net.

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Anonymous

The article was a reasonable overview, and some of the science was interesting, but I was amused at how some scientists are having a hard time measuring the spiritual life.

There was one big error: AA members are not required to announce their faults publicly to their home group. The author of the article was mixing up Steps 4-7 (primarily Step 5, which is done in private with a trusted, experienced individual and your higher power) with the practice of having a speaker at a group — an AA member who voluntarily discloses whatever he or she wishes to disclose.

With 21 years of sobriety in AA, I can definitely say it’s turned my life around. I have a very good job and family, and I am at peace most of the time and do not desire alcohol anymore. I know many very successful people in AA. These are always the people who really understand it, work at it, and follow a spiritual path.

Until you experience a spiritual awakening and practice the principles daily (which include prayer, meditation, amends, and working with others), whether through AA or church or something else, I don’t think it’s possible to understand the truth and beauty of such a life. When you’ve been through it, you know it’s real.
FriendNdeed

Religion says “There’s a God and He believes on in a certain church/mosque/synagog”. AA spiritualism says “There’s a God. Period.”….they leave off the “and” part. You may never understand AA if you miss the difference. I see two groups pissed off at AA. 1) Those who resent AA for leaving out the church part, or 2) Those who resent AA for even mentioning God. AA gets attacked by athiest for mentioning God and by church folk for not embracing church doctrines. The more success that AA achieves, the more these same groups will attack it. Live and let live, baby!
- Quiche de Resistance
  
  I don’t think there’s much in the way of religious people resentful of AA for leaving out a specific religious doctrine. All denominations seem to be happy to rent us their church basements.
- Quiche de Resistance
  
  But in re your 1), there are plenty of butthurt atheists that don’t like the concept of a higher power assisting with recovery (witness this thread). There are atheist/agnostic AA groups (they call it quad A) out there, but you’d probably be hard pressed to find them outside of a large city. I know Chicago has them. And I’ve known AA members that are atheists, though they are rare.
Anonymous

AA is working for me…I don’t care what anybody else, inside or outside of the organization, do with themselves. To each his own…and I found mine.
Rob

“* Just keep coming back, because it does work.”

Yeah, nonsense. My dad’s been dry since ’85, went to a couple meetings after rehab and decided it was pointless pontificating and navel gazing. [My summation, not his.]

You know what makes the difference? Deciding to no longer be dependent. Choice is all. AA is BS magical/religious thinking. And screw them for propagating the idea that their solution is the only solution.
- Quiche de Resistance
  
  AA does not claim to be the only solution to alcoholism, just a solution. If you can quit or control your drinking any other way, our hats are off to you. It’s right in the literature.
FriendNdeed

All addictions have one chemical in common: Endorphins. Nature’s painkiller is released at wound sites (Self-Cutters Anonymous), hair-pulling (Trichotillomania Anonymous), gastrointestinal trauma (Overeaters, Anorexics, Bulemics Anonymous). It also released during terror/euphoric episodes (Sexaholics Anonymous, Gamblers Anonymous, Abusers Anonymous). WHAT’S THAT GOT TO DO WITH A.A.? Dr. SIlkworth treated 5,000 chronic alcoholics before AA was founded. He said those alcoholics suffer an allergy to alcohol. Some people think he was either naive, ignorant, or making excuses for a bad habit. But the truth is that allergies release enormous amounts of Endorphins. You think Uncle Bob’s getting drunk off what’s in his beer mug. In truth, he’s getting stoned off of his body’s own Endorphins. Don’t believe me? Then Google “Allergy” and “Endorphins”. The immune system changes when one believes in God. Google “Immunology” and “spiritual”. Then you’ll see what AA is striving for.
Gumbo

Jerril,

Claiming that human behavior is not best explained by brain processes is not denying that mind equals brain. Even if mental activity could theoretically be reduced to neural activity (which is a matter of debate and practically we are far from it), it doesn’t mean that human behavior is best explained at the level of neurons.

Let’s say I was actually very angered everytime I read about brains and this would correspond to some sort of chemical reaction in my brain (reduced levels of dopamine or whatever), would you say that this chemistry causes or explains my anger or my comments?

No, because you already gave a better explanation – I might have ideas about humans being fundamentally different from other animals. This explanation has to do with how I experience myself and the world.

Although psychopharmacological drugs act directly on the brain, many therapies or groups, including AA, do not. Conversing directly with the prefrontal cortex is not possible – people talk to people and the brain may or may not change as a consequence.
Gumbo

Recovery or well-being of an alcoholic after having shared their experiences with other people and received support is not caused by the chemistry of the prefrontal cortex or other gray or white lumps of protein or fat inside his skull!

When people take therapy or join support groups, they often gain a new perspective on themselves and others and this is sometimes enough to change their habits or eliminate their need to escape or numb themselves through alcohol.

Sure, the chemistry of the brain may change as a consequence of this, but I think saying that people change not through self-awareness itself, but through how self-awareness affects the brain is getting things completely backwards.

Although examining things like brain activity or our evolutionary past (another popular culprit for everything we think or feel) can help us understand human behavior, we are too complex and self-reflective to be reduced to this.
- Jerril
  
  Gumbo – saying that it isn’t caused by the brain, is saying the persons mind isn’t their brain.
  
  There is no mind/brain separation, the mind doesn’t “live” in the brain like a snail in a shell – the brain is the mind.
  
  Denying the inherently physical nature of the mind because it reminds you that you are just another animal won’t change that, and getting angry at other people for talking about brains won’t help either.
  
  Yes of COURSE the AA member talks to people, and people talk to him/her, and therapy happens. Therapy for a damaged arm makes changes in the physical/chemical operation of the arm. Therapy for a damaged brain makes changes to the physical/chemical nature of the brain. When it works.
IWood

Meh. I just replaced alcohol with L-DOPA, bupropion, and aripiprazole, and now I’m a frickin’ dopaminergic centurion with the brain chemistry of a god.
Random Royalty

AA has never claimed to be a “cure” for alcoholism. So talking about “success rates” as if it was some kind of competition for dollars or minds or whatever, just doesn’t make sense.

AA treats alcoholism as a disease that CAN be arrested, but not cured. This does not reject science coming up with a cure, but it is not the goal of AA to find it or compete with it.

The main thrust of the program is spirituality. In AA it means mainly giving up the idea that you are the center of the universe and in control of events outside of yourself.

From a scientific standpoint, giving up control removes much of the anxiety that leads people to compulsive behavior and self-medication through alcohol.

This attitude is summed up in the serenity prayer.

It is very simple to understand but notoriously difficult to put consistently in practice.
- Anonymous
  
  “AA has never claimed to be a “cure” for alcoholism. So talking about “success rates” as if it was some kind of competition for dollars or minds or whatever, just doesn’t make sense.
  
  AA treats alcoholism as a disease that CAN be arrested, but not cured. This does not reject science coming up with a cure, but it is not the goal of AA to find it or compete with it.
  
  The main thrust of the program is spirituality. In AA it means mainly giving up the idea that you are the center of the universe and in control of events outside of yourself.
  
  From a scientific standpoint, giving up control removes much of the anxiety that leads people to compulsive behavior and self-medication through alcohol.
  
  This attitude is summed up in the serenity prayer.
  
  It is very simple to understand but notoriously difficult to put consistently in practice.”
  
  I’m ok with AA in general, but your argument sounds like someone describing the existence of dowsing, and why it falls flat when observed under controlled circumstances.
  
  “How do I know it works? Because I see it work” is a terribly aggravating statement that people put forth on nearly every woo-ish subject.
Anonymous

I’m a sober member of A. A. since1964, when I was 21 years old.
I’ll be going to the same gruop meeting I attendedin 1964 tonight; same room and I think fewer people than back then.
I’d peg the ‘success rate’ of A. A. at about2%, perhaps not even that high.
If it were much higher we’d be meeting in Yankee Stadium each night.
Any group with a less than 2% recovery rate should be looking at why that is and what they might do about that, if they want to help fellow alcoholics deal with their disease.
Over 46 years I’ve seen A. A. become much more dogmatic, religious, doctrinaire, conservative and less inviting of those who don’t believe in G_d. As do most organizations over time.
Mu guess is that over time there will be red meetings, and blue meetings. More religious and less religious.
More rigid and those more liberal.
And so it goes.
I asked Bill Wilson in 1969 when we sat next to each other for a long dinner what he thought might endanger the continued existence of A. A. as we knew it.

‘THE G_D BUSINESS!’ he shot back in a New York minute.
And that was 41 years ago!
Snig

I’ve no personal experience with either, but there’s a parallel group that’s similar doesn’t do the quasi-religous part of AA. Called Rational Recovery. Wiki says it’s a for-profit, and has balkanized, as for profits often do.
http://en.wikipedia.org/wiki/Rational_Recovery
- Anonymous
  
  Rational Recovery is how I quit drinking four years ago, and I didn’t pay a dime.
  
  While the couple that run the website do sell tapes and such, they state right off the bat that everything you need to quit is right on the website for free.
  
  I took this approach because I simply couldn’t embrace A.A. While I acknowledge that it really does help some people, I knew it was never going to work me.
  
  As a Buddhist of 20 years, the very steps of A.A. run completely counter to my beliefs. Folks can say it’s merely a spiritual program all they want, but it’s a decidedly Christian program. Three of the steps themselves are the exact opposite of the foundation of my Faith.
  
  Rational Recovery talks specifically about the brain’s response to drugs/alcohol, and it made sense to me. I quit that day, and I’ve never looked back. I myself was astonished (I drank a liter and half of wine a day), and a month later had a lovely conversation with the wife of the founder about it. I do believe that they’re in it to help folks and that making money is far down the list.
  
  Rational Recovery split from SMART recovery because (interestingly) SMART wanted continue to hold groups, and particularly get into the prison system and just generally be a part of the addiction industry.
  
  Beyond the ideological differences, that’s my main beef with A.A. – a lot of municipalities have one addiction plan: a fleet of white vans that drive you to the nearest meeting.
Anonymous

17 years ago, I was drinking myself to death. I’m a psychiatrist and psychoanalyst and back then, I didn’t think AA would work. It was too simplistic. But then I started AA and have been involved continuously ever since. I haven’t had a drink in the last 17 years. I wonder if it’s helping?
- dragonfly10305
  
  “17 years ago, I was drinking myself to death. I’m a psychiatrist and psychoanalyst and back then, I didn’t think AA would work. It was too simplistic. But then I started AA and have been involved continuously ever since. I haven’t had a drink in the last 17 years. I wonder if it’s helping?”
  
  It might be ‘helping’ – but how much can it be helping if 17 years later, you are still “involved” and don’t feel you can even have one drink? When do you get back to normal life and getting over the problem you HAD over a decade ago?
  
  I have known many people who felt they were drinking too much; it was beginning to negatively impact their life – so some of them decided to quit drinking completely, many of them just decided to cut down and use some moderation.
  I’ve seen those people have better success than those who joined AA.
  
  @Chanttojah –
  “if you don’t want to admin you are an alcoholic and stop drinking because you are afraid that AA is going to rape you
  that’s your business.”
  
  Umm… where in anything I posted did you see anything about if I drink, if I ever drank, let alone whether or not I might drink heavily?
  That’s another problem with AA – the inclusive sense that everyone outside the little “saved” group has a problem. (ASS-U-ME)
  
  @W0rn808
  “You can look up ANYTHING on Google and find negative stuff (some true, some made up, some simply rumours) about it.”
  
  Yep, true. I just looked it up because as far as the “thirteenth step” thing, I was simply going on what one single person I knew had told me – and that’s anecdotal evidence. This guy wasn’t what you’d call the sensitive type, either, but he said: “the stuff that goes on just isn’t right.” (as far as people at a low point in their lives getting taken advantage of).
  So I checked other sources to show that this was not an isolated incident that my acquaintance experienced, but something that is widely acknowledged and spoken of.
  
  However, all this diverges from the main point of: AA is inherently flawed (and often harmful) because it denies that people can take charge of their own lives and FULLY GET OVER a problem.
  - Quiche de Resistance
    
    Here’s some anecdotal evidence for you: 12 years, meetings in Chicago, New York, New Orleans, Newport Beach, Manchester, Aruba, Fairbanks, Cincinnati, Toronto, and thirteenth stepping as you described is virtually non-existant. As mentioned by another commentor, sponsors are not assigned they are chosen by the sponsee and are almost always of the same sex. AA didn’t work for your friend. That’s fine, it doesn’t for everyone. You apparently don’t like it, but who cares, if you’re not an alcoholic. And you obviously don’t know what you’re talking about.
    - dragonfly10305
      
      “12 years, meetings in Chicago, New York, New Orleans, Newport Beach, Manchester, Aruba, Fairbanks, Cincinnati, Toronto, and thirteenth stepping as you described is virtually non-existant.”
      
      OK, here’s a parallel argument:
      I’ve been to Catholic churches, visited and attended services at churches in different cities and countries around the world. I’ve talked to a lot of Catholics. I’ve never actually SEEN a Catholic priest molest a boy. Therefore, priests who molest are virtually nonexistent.
      
      ???
      
      But – as a previous poster stated, indeed, it would be unusual if no vulnerable person ever got taken advantage of, and it’s a situation that would be hard to stop. I doubt all the people talking about it online are lying about their personal experiences… why would they?
      
      Still, that’s not the major issue to me, as I said before.
      You’re right, as a person without addiction problems I don’t have an inside perspective on it. But I still don’t believe that telling people they are hopeless and helpless is a positive thing. I have seen people truly recover from their problems; and believe it can be done.
      I am sure that stopping completely works far better than moderation for some people; but I think (unlike AA) that moderation is possible for many.
      And I do believe that unless someone is convinced otherwise, that everyone does have the power Within Themselves to help themselves, and that no one should have to be stuck in a cycle of endless meetings.
      As I said before, is going to meetings better than lying drunk in a ditch? Sure! But I think a very similar program could exist which taught people to rely on The Power Within rather than A Higher Power, and which concentrated on actual recovery rather than “once = always”. However, such a program might put people through it and back to regular life fairly quickly, rather than aiming to keep everyone who encountered it in its clutches forever, so it probably wouldn’t grow into a huge network…
wolfiesma

I’ve always wondered about the neuroscience of surrender. Something about that experience exerts a very powerful effect on the brain (and rest of the nervous system.) Maybe it is a sort of survival mechanism? You see its one of the key elements of AA and various other religions. That can’t be an accident.

Everyone acts like surrender is a bad word and implies weakness or something, but it also seems like it is the key to a certain freedom, and maybe peace.

Anyway, good luck to everyone trying to get a handle on their compulsive addictions. Not always an easy thing to do. Just remember… surrender. In yielding, there is strength.
Anonymous

For me, the success rate of AA doesn’t make it any difference. What does make a difference is the fact that it works for me.
Anonymous

AA works. You don’t have to “turn your life over to a higher power” in the sense of “become religious. There are many in AA who are atheists and agnostic. All you have to do is go the meetings, listen,talk, and help newcomers.
Chanttojah

It is absolutely a choice.
for real alcoholics and by real alcoholic I mean the chronic type for whom the AA book was written for

the choice is

A) drink, go permanently insane and or die

B) accept spiritual help

the history of Alcoholism has shown definitely that
Real alcoholics may be able stop or moderate on their
own power. But Real Alcoholics will ALWAYS drink again.

And I know several long time AA members who drank again
that is unfortunately very common.
I have also known several AA members who Died sober.

As a matter of fact most of the first 100 members of AA died drunk.

This is because Alcoholism is a chronic illness much like Diabetes. Treatment facilitates an arrest or a remission from the symptoms
if treatment is stopped or compromised the sufferer is very likely to suffer relapse of symptoms. In the case of Alcoholism one of the symptoms is a relapse into drinking.
WoRN808

Re Dragonfly’s comment about exploitation. You can look up ANYTHING on Google and find negative stuff (some true, some made up, some simply rumours) about it. Search “popcorn” and “danger.” In the five years I’ve been involved in AA, no one is forced to do anything, even to get a mentor. All anyone in AA can do is offer suggestions. In addition, anywhere I have ever gone to a meeting, it is suggested that males get male sponsors and females get female sponsors, IF they even choose to get a sponsor. THE ONLY REQUIREMENT FOR AA MEMBERSHIP IS A DESIRE TO STOP DRINKING. There are no rules, laws, or musts.

It is also suggested that newcomers get the names and phone numbers of others at the meeting. This is great because helping and asking for help are two of the things that help us in our sobriety, also we get phone numbers of others so we can ASK if something seems inappropriate. All people do is go to a public meeting. If someone chooses to have sex with somebody, that’s their choice.

Would you go to an AA meeting and have sex with an alcoholic who may not have is act together? I sure as hell wouldn’t. Are there pervs in AA? I’m sure there are, but I wouldn’t know who they were just like when I walk down the street I don’t know who is a perv and who isn’t.

Someone else claimed that AA tells people to ditch all their friends and family and only hang out with AA. IN MY EXPERIENCE that is incorrect. As I said above, no one is required to do anything in AA. I did NOT ditch my friends and family, I DID however for a few months not hang out with friends while they were actively drinking because I still had the obsession to drink until I had worked the steps. We don’t try to avoid alcohol once we are sober. How could you? Liquor is everywhere. However since I’ve been sober, I now am often at parties with friends, my housemates drink sometime, I eat in places that sell liquor, I work in places that sell liquor, but I have no INTEREST in it.

I have however ditched a lot of friends who party, not becuase they drink, but because I found that they weren’t really friends, that they have alcoholic behavior (lying, manipulating, using, not having their shit together, will spend money on liquor before paying their bills then try to borrow money to pay the bills) and still act like that. Sober, I find conversation with these people to be of little interest.

I was given a second chance at life, I’m not gonna waste it sitting in the bullcrap these people make for themselves. I’ve found a new freedom I didn’t have before. My life is richer than it’s ever been and I don’t need to sit around listening to intoxicated people argue over whether Led Zeppelin is more influential than Kurt Cobain.
raporter1950

Even AA reports a success rate of only 10%. I’m glad for the 10% who quit by using AA. But there is more then one way to stop drinking. Many people are able to stop on their own.

My brother found their reliance on a higher power belittling. The idea that HE could stop, that the power to stop was within him, that he wasn’t too weak or damaged to turn his life around was empowering.

In other words, there is no royal road to (fill in the blank).

What’s unfortunate is how often the courts force people arrested for DWI or DUI to attend AA. Most stop going as soon as they fulfill their court ordered obligation.

Anyhow, good luck to anyone who realizes they drink more then is good for them. If you find a method that works for you, that’s great. Even if it is AA.
Anonymous

AA saved my life.
arikol

More importantly: we don’t know WHETHER it works.

The only numbers which had been released by the AA last I knew showed a success rate which was as low or lower than the success rate by those who decided to quit on their own.
Furthermore, the AA is not good on actually sampling numbers. But those numbers that I’ve seen (estimates) show a success rate of between three and five percent.
- fuzzmello
  
  if you know anything at all about statistics you know that their source must be dependable. if you know anything at all about alcoholics anonymous you know that it is purposefully unorganized from the bottom to the top. that’s a fact that by necessity thwarts conventions like statistical analysis.
  
  your comment reveals that you think you know statistics and trust what you’ve read. more importantly, it reveals your trust is deeply, supremely misplaced in this case.
- Anonymous
  
  actually, we DO know whether it works. It does! FOUR PERCENT OF THE TIME, which is even with just about any method someone endeavours on their own.
  
  What’s more, something with a 4 percent success rate is heavily endorsed by the legal system, and in several states is mad mandatory in drugs-related offenses, even though there is a) an established religious component to the program (you have to believe in SOMETHING SUPERNATURAL), and b) there is separation of church and state in the US.
  
  I can’t say it any better than these guys, (and a couple of assholes thrown in for good measure):
  
  http://www.youtube.com/view_play_list?p=74012831EDF673A8
arikol

Of course, measuring the success rate can be hard just because figuring out the definition of “success rate” can be hard in this case (apart from all the other problems in getting reliable data).

Does success rate mean “quit for life”?
Or “quit for a year”?

Does it mean “if relapses occur, can the person get out again”?

All that good stuff.
libelle

In a conversation with the former head of drug and alcohol rehab at the VA in a large city, I was told that AA is helpful in preventing recidivism for a percentage of the people who are able to quit in the first place.

I was cautioned against considering AA a “cure.” AA should be considered a tool for the post-quitting lifestyle.

The raw recidivism rates of AA attenders and non-AA attenders is roughly the same. For specific individuals, however, it’s not that simple. Evidently, some people cannot successfully stay off drugs/alcohol without it, some people cannot successfully stay off drugs/alcohol regardless, and some people are successful in staying off of drugs/alcohol without AA.
Anonymous

The misinformation posted in the comments about AA is absolutely breathtaking.

1) No one is ever forced to go to AA.
Even defendants in criminal cases can tell the judge or prosecutor that they don’t want to go to AA or NA or CA or whatever.

2) No “public confession” is ever required.
First of all, the 5th step is taken between 2 people; hardly “public”.
Secondly, no one is forced to take the 5th step if they do not want to do so.

3) No one is ever forced to do anything in AA.
I’ve been sober almost 25 years and no one, not even once, not even my sponsor, has ever made me do a single thing. Never. Based on the 12 Traditions–a vital part of AA that is rarely mentioned, likely because it won’t grab as many eyeballs as an expose of the 12 steps–I knew no one could ever make do a damn thing in AA.

If I wanted to keep on drinking, I could keep on drinking and no one could stop me.
If I didn’t want to go to meetings, no one could ever make me go.
If I did not want to put money in the 7th Tradition basket, no one could ever make me.
If I didn’t want to take the steps, no one could ever make me take them.

I was offered the gift of complete freedom in AA.

AA is not for everyone.
Unfortunately, about 30 years ago, “recovery” became an industry, and an extremely profitable industry. To gain credibility (and keep the profit centers–patients–rolling in) treatment centers/facilities all touted their AA connections/adherence/whatever. AA members, wanting to be helpful, welcomed this “connection”.

Unfortunately, it has had the undesired effect of putting AA in the middle of political and medical debates–and, really, debates on how resources (MONEY) will be directed by political and medical entities.

Personally, I think it would be better for AA groups detach themselves from any relationship to any treatment program or court program and no longer sign court/attendance slips at AA meetings.

Drastic? Yes. But perhaps necessary to let the world know that AA really does not want to set political, legal or medical agenda.

Take care of your alcohol or drug problem as you see fit.

I did.

I just found my fit in AA.
Anonymous

This is interesting. Might it mean that the AA approach will work for some addictions (or problems) and not others?
Anonymous

Xeni, thanks for the *, because it does.

I have a 100% success rate with AA. I’ve been off drugs and alcohol for 18+ years. And I’m not religious, or even especially spiritual. I also know a number of other people that AA has worked for, for a long time.

I also happen to be stopping smoking after 40+ years. I’m taking Chantix, and it’s working for me. I’ve heard horror stories from others who tried Chantix, so maybe there are some people who think it’s a cult, or it’s killing people. It’s only been 8 weeks since I stopped, but again, I have a 100% success rate with Chantix, so far.

I’m not sure it matters what you do, as long as you find something that works for you. And support groups, per se, seem to be a good thing.
Anonymous

> Here’s what I hate about AA: It encourages people to believe that they’re not truly responsible for themselves.

The most fundamental and painful parts of the experience of working the steps, and the places at which a remarkable number of people balk, is steps four, nine, and ten. What do those steps involve?

The “searching and fearless moral inventory” in step four is a painstaking and rigorous self-examination whose entire point is to make clear to you the ways in which you are responsible for what you have done, and to develop a conceptual framework for analyzing and understanding what you are doing today.

And making amends, in step nine, is taking that intellectual and emotional realization and backing it up with tangible action by going back to the people who you have injured with your selfishness, self-centeredness, inconsideration, and dishonesty and repairing what it is possible to repair. Even if all you can do is apologize.

The tenth step is a daily practive of examining your conduct and assessing where you have been irresponsible.

It is difficult to imagine a process less geared towards encouraging people to believe that they’re not truly responsible for themselves.
- Antinous / Moderator
  
  It is difficult to imagine a process less geared towards encouraging people to believe that they’re not truly responsible for themselves.
  
  Maybe it’s just a coincidence that the several dozen people that I know who are in the program just go through the motions. Or maybe that’s what most everybody does.
  - Anonymous
    
    I think that the bulk of people who go to AA, and do not, long term, stay sober, fall into the ‘motions’ category. Indeed, those that DO achieve stringing a few days sober in a row, then drink and return, report ‘resting on their laurels.’ Humans get lazy and go through the motions. I have fallen into that category, and the shithole I have turned my life into has made me realize that I need to (A) not drink, preferably ever, I mean really, I’ve had my share, and (B) if I possessed the wherewithal to change my situation, I sure as shit would have done it by now, because this really sucks. Today, I asked another man to take me through the steps.
    
    Additionally, if you want to measure success rates, AA’s standard is one person, sober, for one day = success.
Anonymous

is it a myth that the guy who created AA received the advice from a Ouija board?
- Anonymous
  
  Yes – check Wikipedia.
  
  The real origins of AA are no less disturbing for me. It was actually an offshoot of a cult-y Christian organization called the Oxford Group.
  
  I don’t doubt the motives and intentions of Bob and Bill (who knew their little group would become a billion dollar industry?), and given the gin-soaked time period they were living in, their recovery was certainly miraculous for them.
  
  I’ve got my problems with A.A., but I don’t doubt that for the people it helps, it really helps.
ethicalcannibal

I remember something about there being some discussion on AA not working. I know Penn and Teller’s show pointed in that direction. I don’t know if they were right, but I keep thinking I read something about it somewhere else, too.

I think Arikol is right with a success rate of between 3-5%. If that’s true, that is the same success rate for some populations without intervention at all. (It’s been a long time since that part of my nursing education, but I seem to remember it that way.)
agnot

Although I didn’t read far into the article, I was surprised to see Bill Wilson called *the* founder, ostensibly after finding God in a hospital bed.

Bill Wilson got his sobriety and ideas from the “Oxford Group.” He then took his ideas to Dr. Bob Smith, who could not stay sober until their discussion. Together they founded AA.

It is very had to measure success at quiting anything under any method. The “recidivism” rates are high. How, then, does one measure final success? Maybe, given that one does not die of the habit, accumulating substantial years not practicing the habit prior to death. But even then, one may have decided to restart the habit were their impending death proving difficult, rather than because of relapse. Or would that just be another excuse?

Habits, addictions and compulsive behavior, their nature, existence and resolution can require much translation and involve lots of opinion.
- stevew
  
  People do die of the habit. Livers fail. Drunks kill themselves and others daily with bad choices, automobiles, guns, poor diets, missing their doctor prescribed medications, heart disease, stroke and for some the white matter in their brains breaks down leading to dementia. Just my observations from my family and friends who are gone now. About 15% of the Northern European genetic stock has the propensity to become an alcoholic. Mongols and their American Indian descendants metabolize alcohol poorly.
  
  Add in a dose of OCD and any of the pleasure triggering drugs will kill, because like the rats in the cocaine experiments they’d rather press the pleasure pedal than the food one. Cocaine, opiates, nicotine, alcohol are all hard to quit and impossible for some.
  
  I quit 25 years ago. Attended one Al Anon meeting after placing my father in a dementia ward and thought it was a bad joke.
  - agnot
    
    Certainly people die of bad habits. I wouldn’t be surprised, although I hope otherwise, if it were a majority.
    
    My point is how difficult it is to measure success. Since bad habits can return throughout a person’s life, and since most do not quit with the first try, the only indisputable measure is examination of a person’s success after s/he is gone.
    
    Did they die using or not? If so, what amount of the success, if any, should count towards a statistic?
    
    Was their rectified life substantial or just a last minute thing as they became so sick as to final be forced into quiting?
    
    Was their habit really a killer habit or just the dubious luxury of a person with good reason not to be to happy about life?
    
    Were the times they were using maybe a necessary psychological escape?
    
    Did they actually replace one bad habit with another rather than start a new life?
    
    What are the definitions and diagnosis? The medical profession is not settled on that.
    
    Habits, good and bad, are part of life. Some people grow through with more grace than others.
    
    Statistics are a dubious method of measuring success. As with all things in life, if it works for you, it is right.
    
    But I didn’t read the article because of its odd start with a strange interpretations of the historical facts of AA.
    
    BTW, congrats on the 25 years.
Nadreck

Bah, let’s take a leaf from the War On Some People Who Use Some Drugs; dump everyone who has a substance abuse problem into prison for some anal rape; give them a criminal record so they can never work again; and, if they’re a major wage earner, dump their family into the street. Isn’t that the solution to all our health problems: obesity, overly salty foods….
proletariat

How does it work? Nobody really knows.*

* Just keep coming back, because it does work.

** And if AA doesn’t work for you, don’t be discouraged by the cult-like insistence that AA is the only possible solution. Recognize that, however it is accomplished, staying sober is the most important goal.
Anonymous

> when a person joins AA (he said especially young women) they are assigned a “mentor” and that it is pretty much assumed that the mentor will get to sleep with her.

This isn’t right. This isn’t even wrong.

Nobody is “assigned” anything in AA. Nobody has the power to assign.

It’s useful to look at the “13th step” in it context. It’s a sardonic joke. The full joke is: “13. Sleep with a newcomer. 14. Get your teeth fixed. 15. Get a job.”

In case you don’t understand the joke: people in early sobriety make a bunch of awkward steps at trying to live a normal life. Sleeping with a newcomer is one of those things that seems like a good idea at the time to nearly everyone – you’ve been alone for a long time, and now you’re starting to feel fit to try having a relationship, and who are the new people that you’re meeting, since pretty much the entirety of your social life comes from the meetings you’ve been going to every day for the last 12-18 months?

It’s generally a pretty bad idea. Here’s a news flash: among a large social group made up entirely of recovering alcoholics, with no organizational structure or central authority of any kind, people are going to have bad ideas and act on them.
Anonymous

“The AA” has done great things for many people’s lives, some of which had no other option, or means of assistance to afford an option. Alcoholics Anonymous is not good at sampling numbers because of its nature. Successful members consider that one life made better is proof enough that its existence is worthwhile. Given that AA costs nothing for society to maintain (a buck per meeting for coffee supplies, if you have a buck!), I would say it’s a pretty good deal for people who want to take advantage of it. Like many things, however, it only works if you honestly want it to.
- drewstarr
  
  “Given that AA costs nothing for society to maintain (a buck per meeting for coffee supplies, if you have a buck!)”
  
  Um, boy do you have that wrong. Opportunity costs are costs as well. When you stick somebody in a “treatment” program like AA that provides no actual treatment, that addict is immediately unlikely to seek actual medical attention for their actual medical problem.
  
  AA (and its brethren *A groups) are no better than Scientology’s *Anon groups. Your intentions in running such a program or irrelevant (the road to hell, natch), just your results. These programs effectively are killing people.
  - Anonymous
    
    Some people have no other opportunity. I am one who is sober now, not homeless anymore, and looking forward to living much longer that I would have without AA. I feel confident that I could not have done it without the support of others who have a similar affliction. I was not “stuck” into AA and have never heard a member refer to it as treatment. It is more of a method of re-examination of choices that lead to abuse. It was where I turned, I am actually still agnostic, and after 3 years I have yet to see AA kill anyone.
  - robgotabingbang
    
    Like everything, there’s a golden mean here, too. These programs have helped some people and been totally ineffective for others. Yet, contrary to what you haphazardly typed, they are far from “effectively killing people”. They are also no panacean, surefire methods for treating addiction as some on the other side of the coin would believe. Like talk therapy, they are based on theory, not science, and they represent our best guess thus far about the nature of addiction. And we have a long way to go.
  - Axe7540
    
    AA does work for some people. Some people I’ve known couldn’t afford treatment centers and didn’t have insurance that covered hospitalization for dependency. Others aren’t willing to take that big of a first step. AA is easy to get to and well known so it is a good option for people that need help. Plus I’m not sure about the effectiveness of the medical treatments you suggest. Having a variety of options seems to me to be the best approach.
Anonymous

I quit drinking over a year ago and went to one or two meetings a week. The idea of powerlessness and turning my life over to a higher power are great ideas to think about and to talk about with other people. One of the tough things about quitting drinking is that for an alcoholic, nearly all social contact is done with the help of alcohol. I spent much of the time at or after meetings talking to people about how they felt about powerlessness/higher power. It helped me relearn how to talk to other people without alcohol and kick-started my brain back into the wonder and curiousity that kind of falls to the wayside when living a life consumed with the obsession to drink. At this point in my life, I like most people I met at meetings, do not feel powerless or believe in a higher power, but I do think its helped a great deal to sit in a room full of people whose ideas I may or may not agree with and just listen and offer compassion. The bottom line for me is that aa is not a medical treatment and should not be viewed as such. I also think that the law should not force people into it because it is a religious organization. One of the great joys of life is discussing different ideas and aa is a great way to get religious/non-religious, wealthy/poor, conservative/liberal people together where the idea is to support each other as a human being and also sit quietly and listen to what everyone else is saying. If some want to follow it like a cult, great. We know who those people are in meetings and nobody wants to be like them!
Anonymous

“Secret of AA: After 75 Years, We Don’t Know How It Works”

Wrong question. Before you ask how something works you must first ask if it works in the first place. The imagined success of AA far exceeds the sketchily documented success rates, which are as low as 5% and isn’t necessarily proven to be more effective than other programs or none, in spite of the testimonials of the people who do succeed with AA.

When it comes to programs to prevent or treat drug and alcohol abuse there is a great deal of misinformation combined with a social, political and personal desire to latch on to and support established programs that are purported to work rather than proven to work. Just look at the strong support for the DARE (Drug Abuse Resistance Education) program which multiple studies have shown to either not work but or to actually *increase* rates of drug abuse. However, DARE continues to be promoted.

AA has near legendary status, and the force of law, with many offenders sentenced specifically to AA’s non-denominational but undeniably religiously based program as the only alternative to harsher penalties. The Wired article does mention AA’s lack of proven success vs. other programs, but generally glosses over that fact, as the presumptuous title which assumes facts not in evidence demonstrates.
- jeligula
  
  I remember when they first introduced the DARE program back in the early 80′s. The banners were everywhere and they painted a police car with the DARE logo and colors. But nobody explained it to us. It was everywhere, but no definition for the acronym or what it represented. Put it out there for awareness and then explain what it meant when it was on everybody’s minds, was their thinking. But it completely backfired. To a curious 14 year old, it meant something entirely different. Since it was somewhat obvious that it had something to do with drugs, I just assumed it meant “Drugs Are Really Exciting.” Nobody told me any different. Had they explained it from the very beginning, it would have had a different impact. As they did it, it only made the forbidden more attractive. Idiots.
Antinous / Moderator

they are assigned a “mentor” and that it is pretty much assumed that the mentor will get to sleep with her.

That’s called a sponsor. I live in the rehab capital of the world, Palm Springs, and know dozens of people in the program. I’ve never heard of anyone sleeping with a sponsor.

Here’s what I hate about AA: It encourages people to believe that they’re not truly responsible for themselves. Maybe the addicts that I know are unusually fucked up, but the mindset is that they are destined to be addicts by god/genetics/whatever and all that they can do is fight lifelong against this predestination.

Here’s a hideous example. Two friends in the program, married to each other. She’s pregnant. Her: “Do you think the baby will grow up to be an addict?” Him: “I don’t see how he couldn’t, since we are.” Of course he’s going to grow up to be an addict with that attitude hanging over him.

So why are they addicts in the first place? His parents handed him over to a pedophile when he was eight who traded vodka shots for blowjobs. And her? Raised as a Jehovah’s Witness, which along with other strict religious sects is a major cause of alcoholism. Has either of them ever gone to psychotherapy to address the underlying causes of their addiction? Of course not. Why fight that which the universe hath ordained?

And this same couple recently defaulted on $800,000 worth of debt. While their house was in foreclosure, while they had to close their bank accounts before they were seized, while they wouldn’t answer the door for fear of paper-servers, they went on a cruise and bought a racing bike, a set of golf clubs and lord knows what else. They’re now living in an unplumbed trailer in a Florida swamp with his sister and her products of sibling incest.

Their problem is not addiction. Their problem is refusal to take any personal responsibility for their actions, and AA, or at least their interpretation of it, encourages them to keep fucking up and release it to a higher power. Hmmm, what religion does that make me think of?
- dw_funk
  
  Here’s what I hate about AA: It encourages people to believe that they’re not truly responsible for themselves.
  
  Certainly, the vast majority of religions encourage people to believe they’re not truly responsible for themselves; I’d also throw in quite a few governments, educational systems, and societies, too. I’m not saying that’s right. But it clearly works for people, since religion is still pretty popular.
  
  As for your anecdote: yikes. I disagree that psychotherapy would really do any more good than AA; like I said above (along with the Wired article), AA probably provides all the same benefits as psychotherapy. It just has a different set of unscientific therapeutic mythologies.
  
  Personal responsibility is a scarce resource, and I can’t say I’ve met many addicts who exhibit much of it. Or most anybody else, for that matter.
- Anonymous
  
  Here’s what I hate about people who ascribed their own problems with religion, society, whatever, to AA: they’re too full of their own b.s. to grasp the wonder of this truly open-source program. Antinous, none of what you believe about AA with regard to personal responsiblity or to religion is true. You know an awful lot about the lives of those unfortunate individuals. Did you know that AA encourages members to seek professional help where ever necessary? You say these two people are addicts because… In AA we say that alcoholism is but a symptom of a deeper soul sickness (or psychic sickness, if you prefer).
  â€œThere is a principle which is a bar against all information, which is proof against all arguments and which cannot fail to keep a man in everlasting ignorance â€” that principle is contempt prior to investigation.â€ -Herbert Spencer
Anonymous

How about some evidence? http://www2.cochrane.org/reviews/en/ab005032.html
WoRN808

If the judicial refers people to AA because judges mistakenly think that it’s the best option and people die instead of recover, it’s not AA’s fault, it’s the fault of the judge. Everyone including judges should understand that AA, when it works at all, works if the alcoholic WANTS to get sober, not if the alcoholic NEEDS to get sober. Huge difference.

AA is not a conspiracy out to control the world of recovery. It is a large organization and you hear a lot about it, but it is a group of people who are all there voluntarily (except for the above mentioned people who are sent there by judges – but again this has nothing to do with AA) to help each other stay sober.

It is a spiritually based program. If that’s not your cup of tea, by all means try something else. From page XXI from the second edition of the book Alcoholics Anonymous “Upon therapy for the alcoholic himself, we surely have no monopoly. Yet it is our great hope that all those who have as yet found no answer may begin to find one in the pages of this book and will presently join us on the highroad to a new freedom.”

After 25 years of rampant alcoholism and numerous attempts to quit, I came to a point where I could no longer live with alcohol, but I could no longer live without it. I went to AA and followed their suggestions. These people helped me to stay focused on sobriety, focused on staying away from a drink one day at a time and after a few months, without me even noticing it, the obsesson and craving for alcohol went away. If it was a matter of will power or struggle, I’m pretty sure I’d be back to my old misery.

One thing that helps me stay quit (for 5+ years now) is helping others who want to try AA. There is a pleasure in watching others get better. Not everyone makes it, I personally know several who died. There are no guarantees in any treatment option and I often wonder why so many who cling to AA as if it’s their only option. I’ve never suggested that to anyone.

The thing I appreciate about getting sober in AA is that quitting drinking is only the beginning. The learning how to better live life (admitting full well that in my 25 years of alcoholism, I never grew up as a human being and lack most of the coping and relationship skills most -but not all- non alcoholics have) is what makes sobriety so awesome for me. Again, if it was just a matter of removing the alcohol and me being left to deal with all the mess of my screwed up self-centered alcoholic life without alcohol, the pain would probably have been unbearable and I inevitably would have to reach for another drink. I had to learn how to “do life.”
Anonymous

Of course, if AA doesn’t work, you could always look for a bleeding statue:

http://en.wikipedia.org/wiki/Bloody_Mary_%28South_Park%29
Anonymous

In college, I read an excellent article by psychologist Gregory Bateson from 1939′s ‘Ecology of the Mind’ about the cybernetics (“system of control”) of AA. Let me see if I can find it…oh, here, someone posted it:

jpmgoncalves.home.sapo.pt/textos/the_cybernetics_of_self.doc

Fascinating, highly recommended. He got farther in 1939 than this Wired article, in some ways.
dw_funk

“…an indicative transposition like `I’m here But For the Grace of God’ is, she says, literally senseless, and regardless of whether she hears it or not it’s meaningless, and that the foamy enthusiasm with which these folks can say what in fact means nothing at all makes her want to put her head in a Radarange at the thought that Substances have brought her to the sort of pass where this is the sort of language she has to have Blind Faith in.”

David Foster Wallace knew why AA works. And doesn’t work. And that’s just the only good quote I found online; Infinite Jest has a good hundred pages of just AA meetings.

For me, I think AA is a relatively cheap investment, and likely provides most of the benefits you would otherwise receive in any other treatment option available: group therapy, a supporting community (when most support is likely already gone), and the mere attention given to members. Sure, it’s dressed up in a bunch of higher power rhetoric, but I imagine the only difference between the Betty Ford Clinic and your average AA meeting is reflected by the numbers in your checking account.

You have to want to get better. Of course AA will show a lower rate of recovery; it’s free, and “when you ain’t got nothing, you got nothing to lose.”
dw_funk

Also, one assumes that while the coffee is better at the Betty Ford Clinic, it would be much harder to bum a cigarette.
djfatsostupid

I just wanted to make sure that the people who were saying that alcoholics need spirituality to quit and the people who are saying that spirituality is not the route to quitting are aware of the fact that they sound equally ridiculous. Different people are, in fact, different.

Moreover, the idea that AA works 5% of the time and that just deciding to quit works 5% of the time, if true, doesn’t mean that AA is ineffective unless you can prove that it is the *same* 5%. Considering the stories here of people who found AA ridiculous but then quit themselves, and the people who couldn’t quit until they found AA, it is pretty reasonable to guess that the methods are effective for different people.

As for AA being a haven for sexual exploitation, I would but a little bit surprised if it wasn’t. It’s a situation where vulnerable people spend time alone with less vulnerable people, which means it is high risk for sexual abuse. While this is a bad thing, the solution can’t be for vulnerable people to spend time alone with other people, and I don’t see any argument that there is any other thing about AA itself that is causing the problem.

Finally, I do totally believe in powers higher than myself. A monster truck can certainly put out more kilogram meters squared per second cubed than I can. Used appropriately, it can also probably prevent me from drinking.
dollarama

***I just submitted this anonymously, but changed my mind and want to submit it with my account. please disregard the anonymous version? thank you***

I’ve struggled with addiction recently. For me, it took a drastically painful event in my life to get me to stop. I stopped without having to join a group, somehow having found it within myself. The alternative was impossible for me to accept. I lost 4 years of my life and refused to lose any more.

Up until that point, I could always, ALWAYS rationalize it, find some excuse to get away and take my drug one more time.

I consider myself fortunate to have been able to do it on my own. I don’t follow Christianity and so I may not have stuck with AA for the full 12 steps, if I’d joined.

But I say, thank goodness for AA, because I know what it feels like to be trapped inside an addiction. At least they are TRYING to help people who are lonely as f*ck, dying inside, and who mainly just need to talk to someone about it. Probably the best things about AA are 1) They are super accessible to anyone and 2) practically free.

For some people, AA can be like a life raft when you’re drowning in a violent sea. They will always welcome you in. I know what that violent sea can be like, When you have no one to talk to because you’ve alienated all your friends and family. Who cares if the raft is full of Christians, they’re trying to save your life! An addiction, especially alcoholism, is literally a matter of life and death. Just get in the raft.

I think AA does way more good than harm.
Chanttojah

The largest segment of “AA failures” result from Non-Alcoholic hard drinkers, Non-Alcoholic Drug Addicts and people who are not Alcoholic but who have emotional problems. These cases end up in AA for one reason or another after having been “Sentenced” to AA. Either by the courts or by there therapist. These cases cannot succeed because they cannot take the first step in AA which is to admin you have been absolutely beaten by Alcohol. AND that you have failed at life with no way to remedy these conditions on your own.

The next largest segment of “AA failures” results from AA members who are staying sober but who are NON Alcoholic. These AA members have essentially and quite effectively redefined the AA program from within to suit there own definition. From this phenomenon the public conception has been that The program of AA is centered around the attendance of AA meetings and “Sharing your problems with a group” this conception is false.

Another “myth” of AA and by far the most destructive one is that AA is about not drinking. Alcoholism has very little to do with Alcohol and much more to do with the spiritual condition and unique thought patterns (Insanity) of the person with alcoholism. There is a component of alcoholism that centers from an allergic reactionwhich only those with alcoholism have. This allergic reaction is arrested immediately when the alcoholic stops ingesting alcohol.

The “program” of AA is based around a vital spiritual idea followed by a very rigorous program of action. which only the most desperate will attempt and complete.

Throughout AAs history only real alcoholics who have hit bottom are “ready” for admission to AA.

AA does not actually get people physically sober. The program of AA, “the 12 steps” are designed to expel the sufferers’ obsession to drink. physical abstinence is the responsibility of the sufferer. AA deals wiith what happens after the Alcoholic stops ingesting Alcohol. The things that occur when the Alcoholic Stops Drinking is really the true nature of Alcoholism.
Anonymous

As long as you approach AA with the expectation that it’s a program to help people quit drinking, you’re going to get confused. AA doesn’t do an especially good (or bad) job at helping people stop drinking. But what it excels at is helping people develop the capacity to find life without alcohol tolerable.

It’s a spiritual program. That is a more than a little hard for people to grasp. They hear “higher power” and “God” and think that it’s a religious program. (For some people, it is.) In my experience, it’s really more a matter of tools. God – more specifically, the idea of God, the complex set of concepts that we develop to help us organize our sense of who and what and where we are in relation to the fabric of reality – is a tool that AAs employ in the service of enlarging their spiritual experience. I myself had a fairly solid conception of God before I first walked in the door, and it really just got in the way because I had no idea of how to use it. I have found my religious background to be at best almost completely irrelevant to the spiritual experience of recovery.

The spiritual experience, on the other hand, has been profound. The program of recovery has changed the kind of person I am. I’m nearly 50 years old. The person I was at 48 was really pretty basically the same as the person I was at 24. The person I am at 49 is substantively different. That has never happened to me before.

There are any number of ways that people can follow to enlarge their spirituality. There aren’t that many that can be followed by the confused and tormented people who are in early recovery, however. If you read the Big Book and think that it seems like an odd and stilted and redundant text, well, it is, but it was written for a really bewildered and damaged audience with a pretty odd perspective. I’m no expert, but I think that most other programs of spiritual practice start off with the expectation that the novice has a lot to learn. AA starts off with the expectation that the novice is nakedly hostile to and resentful of the fact that it’s a program of spiritual practice.

Anyway, the more I come to understand the process of recovery, the less it seems to me that it can usefully be analyzed in any kind of reductionist way. This article’s emphasis on neuroscience isn’t wrong, exactly, but doesn’t seem very relevant either. Our knowledge of the mechanics of addiction is pitiably shallow, and our knowledge of the mechanics of spiritual experience is even shallower. Those of us who have seen the process of recovery in all of its weird and remarkable glory know a lot of things that are both self-evidently true and pretty hard to even conceive of measuring.

Finally on the subject of success rates: I don’t know if AA has been successful for me. I’m beginning to think it has, but I’m only about 18 months sober. What I do know is that it doesn’t work for people who aren’t willing to do it. You can’t persuade people to be willing. You certainly can’t coerce them. I’ve known people who were desperately unhappy and wanted to get free of alcoholism and believed that AA would work for them and *still* couldn’t find the willingness. But people who find that willingness seem to be able to develop the capacities that AA is trying to help them develop, and it guides them to a life that’s worth living. Is that 3% of alcoholics? 10%? I don’t know. It’s really hard for me to think that the number even matters.
Mr. T

AA only really works *if* you can ‘hand your life over’ (to a Higher Power.)

If not, it’s a real struggle.
FriendNdeed

I cannot believe how critical the athiests and hyper-churchly people can get towards AA. They assault the AA solution, even though they have no demonstrable alternative to offer……other pure, random remission. The root of the word “addiction” means “I am owned by another”. Critics snarl, “I don’t want to turn myself over to a *$&# program!” Fine. Then don’t! There are pages and pages of the Big Book describing drinkers who do NOT need AA. Read those pages and if you find yourself in them, close the book. But there are those unfortunates whose lives are owned by alcoholism and they want their lives back. The hairsplitting that critics do doesn’t mean much when someone is working to retrieve their family, their income, their reputation, and their dignity.
dragonfly10305

AA does not and will never work, because they don’t aim or claim to “cure” you.
In their eyes, an alcoholic is always “in recovery,” NEVER cured, never over it.

The very first step of AA is to “admit you are powerless before alcohol”.

This is absolutely the WRONG thing to do. To get over something, the first step MUST be the very opposite – to realize that you absolutely DO have the power to change your behavior, and that you DO have power over your use of alcohol. Only then will someone be able to change.

What AA does (or aims to do) is to replace the addictive dependence on alcohol with addictive dependence on constant meetings (which the beginning of the Wired article points out) and a dependency on club (or cult) membership.

There is no providing, in AA, for a person’s transition to becoming a strong, independent person – they try to make a person internalize “I am and will always be an alcoholic” as a (self-esteem-killing) identity.

They also (don’t know about all groups, but definitely some) actively encourage members to cut off all contact with their friends, assuming that if someone has a problem, ALL of their contacts must be “enablers.” This socially isolates people, and makes them really dependent on their fellow club members (and ripe for exploitation)… I’ve seen that happen.

My perception, on the other hand, is that (unless you really are in a situation where ALL of your friends are crackheads), a person’s friends can be the most important support structure to help someone cut down or stop their drinking, etc.
But AA wants to eliminate all support structure – except for of course, themselves.

I suppose one can argue that going to AA is better than the alternative of letting alcohol take over your life – but from the friends I’ve had who went to AA, it seemed to do more harm than good…
- Quiche de Resistance
  
  I’ve been sober for 12 years in AA and have never seen anyone urged to “cut off all contact with their friends”. The only suggestion is to limit contact with drinking/using buddies, at least initially, to avoid the trigger of being around drinking playgrounds and playmates. This is just sound logic. It is generally encouraged to spend time with family and friends are supporting recovery (at least I suggest it to guys I sponsor).
  
  I find your comment about exploitation offensive. Just how do you think such people are exploited?
  - dragonfly10305
    
    “I find your comment about exploitation offensive. Just how do you think such people are exploited?”
    
    Took me 2 seconds to find this thru google; it pretty much goes along with what a person who was in AA in my city told me… which was that when a person joins AA (he said especially young women) they are assigned a “mentor” and that it is pretty much assumed that the mentor will get to sleep with her. (He used the term here, “Thirteenth-stepping”, too)
    Like I said, I know not all groups are the same… but this is obviously not isolated, either.
    
    “Sexual exploitation of newcomers is so common that they even have a well-known nickname for it: “thirteenth stepping” somebody. (First you teach them the Twelve Steps, and then you get them in bed and teach them the Thirteenth Step.) Women and men, old, young, and younger, straight or lesbian or gay, all can be targets.
    
    It took me only a few hours of searching the Internet for information on A.A. to stumble across many web pages describing thirteenth stepping, written by victims of it themselves, but the national A.A. organizations are claiming to be “shocked” to discover that it exists. On July 5, 2000, a memo from the headquarters of the British A.A. was leaked to the Glasgow, Scotland Herald newspaper, which reported:
    
    Vulnerable alcoholics seeking help for their addiction are being subjected to sexual and other abuse at the hands of long-serving volunteers from the world’s largest alcohol support group.
    An internal memorandum circulated to every Alcoholics Anonymous group in the country reveals that volunteer members are increasingly being investigated by police forces examining allegations of sexual abuse.”
    - Chanttojah
      
      sound like you have some great reasons to drink
    - Chanttojah
      
      if you don’t want to admin you are an alcoholic and stop drinking because you are afraid that AA is going to rape you
      that’s your business.
- Anonymous
  
  Another common misconception people have is that business of admitting powerlessness over alcohol.
  
  If you’re not powerless over alcohol, you don’t need AA.
  
  The first step isn’t just the start of AA’s program of recovery, it’s also, for want of a better phrase, a diagnostic tool.
  
  There are people with drinking problems who aren’t ready to take the first step. The great majority of these people never need to. Because they’re not, in fact, powerless over alcohol. They decide to stop drinking and to live without alcohol, and they’re able to, either by themselves or with medical and/or psychological help.
  
  Does this mean that AA is useless? No. It means that AA isn’t for them.
  
  AA is for people who can’t do that. If you’ve had a drinking problem, gone to AA, thought, “these people are full of shit,” and stopped drinking on your own, it’s natural enough to think that AA is nonsense. That’s the illusion of central position.
  - mdh
    
    bravo. Until you’ve had a close friend or sibling who is truly powerless, or you yourself are, then you might not get it.
A.P. Fergus

It is very had to measure success at quiting anything under any method.

How is this possibly true? If one quits, one is successful. If one doesn’t, they aren’t. We can generalize this to analyze the method with statistics. How many people quit? How many people don’t? If you relapse, you haven’t quit–this seems obvious to me, correct me if I’m wrong. I don’t see how it could get much more straightforward.
Anonymous

AA doesn’t work for atheists and others who do not accept that their is a higher power. The easy way to quit anything is to replace it with something else. Can’t quit smoking? Smoke more weed, Can’t quit drinking, take up smoking. Can’t quit wow, have more sex. It’s called the 13th step, and it works wonders.
Anonymous

“God, grant me the strength to change the things I can. The courage to accept the things I cannot change. And a Ferrari.”
Anonymous

I’m a sober alcoholic in AA. Here’s what powerless means to me —

My body has an abnormal reaction to alcohol than most. When I take a drink, it’s like an “IT’S GO TIME” switch is flipped. Then, not every time, but quite often, I’m loaded. When I don’t take that first, front drink, that powerless isn’t an issue.

Those who are allergic to peanut butter are powerless as to how their bodies process it.
kodiak3

I hit a point in my life where I had lost so much, I knew I had to quit drinking. I started going to AA on my own (not court-ordered), and in the first few months I continued drinking between attending meetings.

The main problem I have with AA is the premise that you have to give yourself up to a “higher power”. Although this doesn’t necessarily have to be God, it does imply something beyond scientific knowledge. Being a very logical/scientific person, I cannot accept something like this and just give myself up to it. The concept does not work on a fundamental level in my head. Some AA people had chosen other higher powers in the program – the ocean, and the “group” come to mind. Am I supposed to pick something I really like and then this object/person/idea will save me?

At some point, and it wasn’t in an AA meeting, I made the decision to stop drinking. I made the choice, and it was my choice – not a higher power making it for me. I haven’t had a drop in almost a year now.

I don’t go to meetings any more. I found my higher power – Me.
- Chanttojah
  
  Means that you are probably not the type of alcoholic whom AA was created for
- Chanttojah
  
  Or
  that you will drink again.
  - kodiak3
    
    Or that I refuse to rely on an imaginary being to make decisions for me.
    - Chanttojah
      
      it is that definition of higher power:
      
      “an imaginary being to make decisions for me”
      
      a very limiting and short sighted definition
      almost like a little child’s definition.
      very much like the definition I used to subscribe to.
      
      The thing is this,
      if you are not alcoholic you will probably be ok.
      and will be able to not drink if you so choose.
      
      If you are a real alcoholic
      who is trying to maintain sobriety on that definition of higher power you will drink again.
      - kodiak3
        
        I think I am a real alcoholic – but maintaining sobriety without a higher power. How many AA mentors and many-years-sober AA people drink again? I heard about it a lot.
        
        Why is it that AA pundits always think you can only be sober if you are involved in AA and believe in a higher power (god)? If you don’t follow the steps and give yourself up to your higher power, you’re doomed.
        
        To me it seems like a choice you are going to make and follow on your own – god or no god, AA or no AA.
      - mdh
        
        to each their own, whatever gets you through the night. Ya know. Don’t fault the crippled for using crutches.
      - kodiak3
        
        I think I am a real alcoholic – but maintaining sobriety without a higher power. How many AA mentors and many-years-sober AA people drink again? I heard about it a lot.
        
        Why is it that AA pundits always think you can only be sober if you are involved in AA and believe in a higher power (god)? If you don’t follow the steps and give yourself up to your higher power, you’re doomed.
        
        To me it seems like a choice you are going to make and follow on your own – god or no god, AA or no AA.
Anonymous

I have a PhD in Social Psychology. I make a living doing research. I am a recovering drug addict who goes to NA meetings almost every day (and have been clean for more than 20 years).

Most people who become involved with drugs do not become “drug addicts.” Some people who become involved with drugs do have it turn into a problem (for them or others). Most of thease people can quit or back-up (use more moderately) on their own. When the drugs stop being fun and start to become a problem most people adjust (punishment/negative reinforcement and all that). None of these people need a 12-step program (although they may benefit from some exposure to it). Rehab should be good enough to do the job. Many won’t even need that.

Anyone can get addicted to an addictive drug. Most people can ween themselves off an addiction, struggle through withdrawal, stop, and STAY STOPPED on their own. This is true even for a big bad heroin addiction. Being addicted to an addictive drug is not what the 12-step programs are addressing.

ADDICTS (and that includes everyone at AA) are an entirely different animal. Entirely. Different. We wind up pressing the bar until we die (or locked up or tied down). It’s not a matter of “just say no,” or “will power,” or “recognizing you have a problem,” or wanting to do something about it, or waiting until the negative consequences become great enough that we naturally adjust. Great rehabs, loving family and friends, great therapy, medication to alleviate withdrawal, and personal determination are irrelevant in the face of a monster obsession and compulsion that is better thought of as being a very peculiar and powerful mental illness than a matter of character or motivation. It’s not about stopping (we can do that a hundred times) or getting through withdrawal, it’s about staying stopped. Addicts can’t stay stopped. Desperately wanting to stay stopped is not sufficient. It’s crazy.

If you are not an ADDICT (if you haven’t experienced this compulsion yourself) you cannot understand this or understand the desperation that can lead one to latch on to a 12-step program…to put up with and willingly engage in a lot of this off-putting stuff (“Higher power,” goofy slogans, working “the steps”). “Stupid stuff” that one gradually comes to be fond of and extremely thankful for (if you’re lucky!). Non-addicts will never get it. I can’t explain it to you because it doesn’t make sense. It’s crazy.

From my point of view, most of the comments here can better be used to indict the state of our science/research and neuropsychology than 12-step programs): why is there so little real scientifically-based help to offer ADDICTS? So little “real” help that a spiritually-based program created by a chance meeting in Akron, Ohio, of two hard-core well-educated alcoholics is still–if they’re lucky–about their only hope? If I were a scientist, I’d be embarrassed. I am. And I am.
- Anonymous
  
  Well said Anon #44.
  
  If you have not crossed the threshold and become addicted you will never understand. We alcoholics use to drink normally, we were lets say cucumbers, now as we continued we became pickles. You cannot convirt a pickel back to being a cucumber.
  
  As we say in AA try 90 meeting in 90 days, if your not a happyier person, we will gladly refund your misery.
  
  It took me 11 years to get two years of consistent sobriety, in part because a had a hard time finding a power greater than myself. You know, it can be anything outside yourself i.e. a tree, a door knob, (that allows you to exit your room), a group as a whole, or anything you can relate to. I have 20 years now and my life is full of things I never dreamed possible.
  
  If you donâ€™t like what AA offers donâ€™t attend. We have saved millions including myself. I will be forever grateful to Bill W., Lois W. and Dr. Bob.
Griffin

“like the rats in the cocaine experiments they’d rather press the pleasure pedal than the food one.”

I was under the impression this had been debunked except in very specific circumstances? From the literature I read, rats who have a strong social system, a family, and a comfortable environment will partake occasionally, but not usually to the point where their life suffers – its only the rats that have absolutely nothing better to do that will kill themselves this way.

Maybe I’m remembering incorrectly though.
Anonymous

The ONLY requirement for AA membership is a desire to stop drinking.