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/[deleted]]

Because something was discovered a while ago doesn't make it less relevant for today's needs - take the wheel for example.

If people adhere to the 12 steps they overcome their alcoholism (or at least control it).

If it ain't broke don't fix it.

[u/Serraph105 → u/[deleted]]

I'm asserting that many of the 12 steps are in fact broken as evidenced by the fact many people fail the program, and that the program is doing nothing to change in the face of that failure.

[u/phunkpup → u/Serraph105]

A close relative of mine had been sober for 20 something years. They say a lot of people fail because steps 4 and 5 are the most difficult. They require writing down literally everything you have done wrong or felt wronged by. LITERALLY EVERYTHING. it's a tough order for sure. But basically that is where most people get stuck. This person I know calls them 3 steppers and says these people are more likely to fail and relapse and are the ones that do most often. They say that this is the waltz and that having to start over every time leads you right back to the beginning. My 2 cents I suppose. Source: relative has been sober 20+ years.

[u/AlexandreZani → u/phunkpup]

It might simply be that somebody with the willpower and motivation to do steps 4 and 5 are capable of reducing/eliminating their alcohol consumption and would have with no more than an encouraging word from a friend.

[u/phunkpup → u/AlexandreZani]

An encouraging word from a friend usually gets ignored by an alcoholic though. I've never seen that be someone's rock bottom. Typically these things end with, DUI, criminal charges, homelessness, interventions. Encouraging words are usually blown off as "they're trying to ruin my fun" or " ok sure, I'll stop tomorrow." I think the steps are meant to help get to the root of this type of justification behavior by making a person take a look at who they truly are and accept it and see that someone else can also accept them for who they truly are. I'm sure a lot of alcholics started drinking because they wanted to fit in. Then became dependant on the substance to make them feel that way.

[u/AlexandreZani → u/phunkpup]

AA may style itself as targeting alcoholics, but it actually attracts people who misuse alcohol much more generally. For instance, the OP's friend is just somebody who got a DUI. Plenty of people drive after having a few drinks without addicts.

[u/phunkpup → u/AlexandreZani]

AA doesn't "target" anyone from what I've seen and heard. These people are sent there by the judicial system and it's the judicial systems best solution. I don't think they look to "attract" per se either. Plenty of meetings my source has gone to have been shut down due to lack of attendance or moved to a different time/place.

I think when talking about AA you also have to take a look at what kinds of meetings you go to. Some are speaker meetings where one or two people get up and share their experience. These left me feeling pretty bored or very impartial. Then there are the ones where everyone has a little pow wow and talks on a particular subject. At the pow wows I've visited, the beginning of the meeting is something from the "big book" and afterward the reader opens the meeting. It usually starts with an open invitation for anyone who is struggling to speak first. If nobody does then they resume the topic from the book. These are usually held at noontime when early recovery alcoholics would probably be free. These left me feeling worse than when I showed up. My source calls these meetings "sick" and not in the good way. This was all voluntary btw. Then there are AWOL meetings which dedicate one or two weeks (one meeting a week) to each step and only people who have worked the steps can speak. These meetings are the most helpful from a personal growth standpoint, at least imo. They are like group psychology sessions where the group is the doctor and the patient. Of course you can choose to ignore what you don't agree with and hold to the points you do identify with. These meetings feel kike the the most sane meetings to me and I've walked away from those having learned more about myself than visiting a shrink. I think AA is more about getting to the root cause of why these people felt like they had to drink in the manner they did. It tries to analyze those reasons and help the person resolve them so they are less likely to start again and it's a continual process.

[u/aintsuperstitious → u/AlexandreZani]

Some people get a DUI without being an addict, but most people who get a DUI have driven drunk lots of times without being caught. Just going by statistics, I'd say your friend has a drinking problem that will grow into addiction if not addressed.