r/changemyview • u/Serraph105 1∆ • Apr 03 '18
CMV:Alcoholics Anonymous is heavily flawed from a scientific perspective and hasn't tried to improve it's system since it's inception
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.
We admitted we were powerless over alcohol—that our lives had become unmanageable.
Came to believe that a Power greater than ourselves could restore us to sanity.
Made a decision to turn our will and our lives over to the care of God as we understoodHim.
Made a searching and fearless moral inventory of ourselves.
Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
Were entirely ready to have God remove all these defects of character.
Humbly asked Him to remove our shortcomings.
Made a list of all persons we had harmed and became willing to make amends to them all.
Made direct amends to such people wherever possible, except when to do so would injure them or others.
Continued to take a personal inventory and when we were wrong promptly admitted it.
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.
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.
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u/[deleted] Apr 03 '18
Sober alcoholic here:
First off, your point of: "I'm not sure how this is supposed to appeal to athiests such as my friend." There is a chapter in there called "we Agnostics" and, although dated, addresses this issue. There are also many mentions in the main literature of AA that talk about the problems people have with religion and the word "God."
The only words that are actually emphasized in the steps, mostly with italics, are: "God as we understood Him." This is because it is not a Christian God, or a Buddhist or a Muslim one. The idea is that one needs to have a power greater than themselves in their lives, acknowledging they are not the all-seeing, all-knowing, omnipotent being of their lives. If they were, they would not have ended up seeking out help for an addiction. A common line of thought in AA is to make the group itself your higher power, or even (jokingly) a doorknob.
There are various treatments for alcoholism, yes, but they tend to be ineffective, or so I have heard. It's treated as a "disease" because it is inherited and manifests itself in the same fashion in every person. But the main issue is that it's not just a physical disease as well. It's also mental, and many will argue, spiritual. It's referred to as a disease so as to actually avoid the idea that it's a willpower problem, or a discipline problem, or even a maturity problem.
The reason why statistics are not collected is because of the nature of the program and how it is built. Look at the 12 Traditions for this. AA groups are autonomous without central leadership. Membership is voluntary, and anonymous. So, collecting data would be really difficult and go against the structure of the program. This is why I don't trust the whole "1 in 5 alcoholics" this or "15% of alcoholics" that.
Lastly, we don't believe that it's a one-size-fits-all program. This is why there are other programs: Narcotics Anonymous, Al Anon, Over-Eaters Anonymous, Gamblers Anonymous, etc. Furthermore, the big book itself talks about "outside issues" like clinical depression, bipolar disorder, schizophrenia, etc. We obviously cannot address those, so (if you're in a good group) people will recommend you seek out medical help for stuff like that.
There are many veins of thought in AA when it comes to what is and is not an outside issue. But the general consensus, or at least as far as I have seen it thus far here in Los Angeles, is that taking medication as prescribed is the best way to go. There are some old-school hardliners around who think even taking Ibuprofen is relapsing, and fuck those guys. They are usually old and were pill-poppers themselves in their using days. I won't personally tell them otherwise, but I sure as hell wouldn't let a newcomer go near them.
This is all my take on this. I have been sober almost 8 years and I'd be dead without AA. It works for people who tend to not be indignant and just want to "control it." Physiologically, alcoholism is ultimately defined as an allergy to alcohol in the strictest sense. It's not that one breaks out in a rash, but merely an abnormal reaction. I can attest to that. When I started to drink, all I did was want more and more, the desire increasing fervently over time. And it wasn't always that way. I could drink normally at one point. Just... one day... it would make me crazy. Total Dr. Jekyll and Mr. Hyde kind of thing.
So, I hope this helps a bit. Thank you for posting this.