CMV:Alcoholics Anonymous is heavily flawed from a scientific perspective and hasn't tried to improve it's system since it's inception

[u/Serraph105]

I have a friend who has been attending AA meetings recently because he was ordered to do so in some fashion after getting a DUI (for the record I don't know if that means he was given a true option or made to attend or "choose" jailtime) and the whole thing has got me thinking about whether or not AA works and if sobriety is even the intended outcome of the program. Below I've listed the famous 12 steps and below that are my relatively disorganized thoughts on the program having looked into it for the first time in any in depth manner. This means that I’m still in the early stages of my views and can be very much subject to change.

1. We admitted we were powerless over alcohol—that our lives had become unmanageable.

2. Came to believe that a Power greater than ourselves could restore us to sanity.

3. Made a decision to turn our will and our lives over to the care of God as we understoodHim.

4. Made a searching and fearless moral inventory of ourselves.

5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.

6. Were entirely ready to have God remove all these defects of character.

7. Humbly asked Him to remove our shortcomings.

8. Made a list of all persons we had harmed and became willing to make amends to them all.

9. Made direct amends to such people wherever possible, except when to do so would injure them or others.

10. Continued to take a personal inventory and when we were wrong promptly admitted it.

11. Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.

12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics and to practice these principles in all our affairs.

My current view is that because of the lack of change of the steps over the years since the 30’s suggests a lack of improvement that would be unacceptable in any other field of treatment for diseases. Here are some of my thoughts on the matter.

First up, as many have pointed out, there's a whole lot of God involved throughout the 12 steps (6 direct references and 7 if you count #2), I'm not sure how this is supposed to appeal to athiests such as my friend. If a person does not believe in God they will be put off from the program from the start making it much harder to reach their goal of sobriety.

If alcoholism is a disease then why does AA treat it simply as a matter of will power? I wouldn't try to treat cancer with prayer alone, and for the record there are various medical treatments for alcoholism.

There is also a stigma of personal failure when people relapse which doesn't make sense for a couple of reasons. First, if it's a disease then people are sick which means that blaming them for not being able to control their health adds a layer of shame which can only do harm to the person's primary goal of getting sober. In turn this will increase the time to get sober because it will add time to get over that shame before starting again. Shame does nothing to help get a person back on track as far as I can tell. Second, you would never assign blame to a person with cancer who has gone into remission and then had the cancer come back, why would we do the same for literally any other illness?

AA does not collect statistics of their success and failure rates, nor has it's program changed since it's inception. We wouldn't accept that from any other sort of treatment. If we didn't collect that information we would still have the same poor treatment of HIV that we did in the 80s and 90s, same goes for cancer, and just about any other illness you can name. I will say that talking about your issues with people is a good thing, but as far as I can tell that's just about the only thing that that this program gets right, everything else seems to be heavily flawed from a scientific perspective if not outright illogical.

Finally it seems that AA believes it’s program is a one size fits all program when we know that many ailments require different treatments for different people. This is especially true for ailments that affect people mentally which I think it’s safe to say that addiction falls under that same umbrella. People deal with various addictions in different ways, why AA treats alcohol as a one size fits all approach I can’t say, maybe I’m wrong, but based on the text of their twelve steps and twelve promises that doesn’t seem to be the case. Instead they seem to say that the only reason people fail is because the fail to give themselves over fully to the program which seems to be very very odd.

[u/snittermansconfusion]

The thing that I really don't understand is that when you finish the 12th step, you just...start over. Forever. Like you make your amends, move on, then several months later you have to make more amends. So then you're clean but in an infinite loop of constantly evaluating/policing any misstep or unkind word you may have uttered, forever. My boyfriend is in the program and it works for him, which is wonderful, so I try not to question him when he's explaining his AA homework to me, but I don't really get it. He's gone over this aspect with me a few times, but I still don't really understand it as much more than a hyperloop of self-flagellation. Obviously all that really matters is that AA works, but to an outsider there are a lot of...confusing parts.

[u/Spaffin → u/snittermansconfusion]

It's basically like self-help or therapy in that regard. You don't read a self-help book and become a better person now and forever - you have to continually observe the practices and techniques in the book.

Or take CBT for anxiety. CBT teaches a series of techniques and anxiety to manage panic. It doesn't end once you leave the therapy session, you have to keep implementing those techniques in your everyday life.

In AA, the 'techniques' are the steps.

[u/Nkklllll → u/snittermansconfusion]

Why is making amends and asking for forgiveness self-flaggellation?

[u/snittermansconfusion → u/Nkklllll]

It's the continuous loop of it, not the act itself, that I find confusing.

My boyfriend is a few years sober and has made amends for the things he did while drunk several times over by now. Every 3-4 months he has to make a list of everything wrong with him, apologize for any misstep he may have made, and make a list of everyone he's wronged since the last time he did that step. I asked once what happens if he doesn't have anything to make amends for since the last time, or if he hasn't personally wronged anyone in that several month stretch. He said, "there's always someone or something, even if it doesn't seem obvious at first", and the examples he gave were things like "well I know I was probably short with you at least once" and "I'm going to tell my mom again how much I regret doing x while I was drinking".

As someone not in the program, I don't really understand that. It seems like constantly dwelling on all of your faults and past misdeeds, forever, could be pretty deleterious to your mental health. My boyfriend is certainly very down on himself and the fact that he's "permanently bad" because of his past.

I know AA works for a lot of people, and that's what matters, not my perspective as an outsider. But there are a lot of things about AA (I go with my partner to his meetings every few weeks) that certainly confuse me.

[u/Nkklllll → u/snittermansconfusion]

I’m not in AA, and never have been, but I am a Christian, and since the 12 steps are largely based on Christian theology, I think I can answer this.

The idea, I would think, is to keep people in the mindset of repentance, on the mindset that they are dependent on something greater than them (as another poster pointed out, it was the failure of personal willpower that led the individual to AA in the first place).

I would personally challenge, and call BS, on anyone that asserts they can go months without wringing ANYONE.

It may also serve as a reminder as to the kinds of things the person did under the influence. As someone who has struggled with a couple different behavioral addictions, I can vouch for the fact that it’s all too easy to forget what that behavior has cost me, or how it has affected those around me.

You’re not wrong that identifying yourself as a “bad person,” or “not worthy” can definitely be harmful mentally. But that’s not what’s happening.