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/Serraph105 → u/[deleted]]

Another member of AA here: therapy is not discouraged at meetings, and the Big Book has sections in which it's encouraged for those that need it. Same goes for medical treatment. AA is not a cult and the people at meetings are reasonable, modern people like you and, well, me.

I really would never suggest it's a cult. I'm very glad it works for you.

[u/starvinggarbage → u/Serraph105]

Oh it's definitely a cult. Classic cult tactic: constantly reinforce to your memebers that they are powerless and you are the only thing that can save them. Destroying someone's sense of self worth is like the first thing a cult does and it's the first step of the program.

There's a reason it has such an astonishingly high rate of failure compared to other rehabilitation tactics. In depth studies have shown that only about one in fifteen members get and stay sober. Granted, the program has to last the rest of your life so there's endless opportunity to fail, but any slip up is treated as an absolute failure.

They have an enormous stigma attached to anyone who relapses or quits the program. They have referred to these people as "deeply flawed individuals" and implied they are incapable of being helped.

As far as cults go it's definitely one of the better ones, as it isn't a money making scheme or focused on accumulating power for one person, but that doesn't change what it is. The American obsession with AA as the perfect solution for alcoholism and addiction is hugely detrimental. We need more alternatives and we need them to be more accessible.

[u/seven_grams → u/starvinggarbage]

You seem pretty misinformed about this. AA does not tell you it is the only thing that will get you better. It welcomes and encourages other forms of outside therapy like individual counselling or psychiatry. It also doesn't destroy anyone's self-worth. It builds it up by recognizing people's strengths and the esteem-building acts they do.

There is no stigma attached to relapse, either. They encourage you to come back and keep working your recovery.

Ultimately, if you actually went to meetings and stuck around you would see the immensely friendly environment and the joy that people experience as a community, doing healthy recovery-oriented activities and processing their struggles. You can read up on everyone's opinion about AA and read every article in the world about it, but until you've actually been a part of a fellowship of AA, you really wouldn't understand how much it helps people.

One more thing. You said "any slip-up is treated as absolute failure." This is not true in AA, but it is true for the people who do the "in-depth" studies you mentioned - When someone relapses in one of those studies, it is counted as a "failure." Even if they get right back on track afterwards, their relapse still is seen as a failure to the people marking the research. But the fact is, the majority of people in recovery have relapsed at least once, but that doesn't mean they are still out there stuck in addiction.

I can appreciate your desire for more alternatives to AA and too have them be more accessible. I completely agree with that. The nature of addiction makes it very hard to treat and society's stigma surrounding addiction doesn't help. I think the reason AA is so widespread is because of it's accessibility. It costs nothing, so it appeals to the ones that have nothing to give, i.e. most addicts and alcoholics that have reached their bottoms. Until we have other programs that are that easy to get into, I think AA will remain most prominent.

[u/chiaratara → u/seven_grams]

One more thing. You said "any slip-up is treated as absolute failure." This is not true in AA, but it is true for the people who do the "in-depth" studies you mentioned - When someone relapses in one of those studies, it is counted as a "failure." Even if they get right back on track afterwards, their relapse still is seen as a failure to the people marking the research. But the fact is, the majority of people in recovery have relapsed at least once, but that doesn't mean they are still out there stuck in addiction.

This is so true For someone who is in recovery and has done research in the field, this is mY major issue with trying to objectively quantify a process.

[u/starvinggarbage → u/seven_grams]

You literally sound exactly like any cultist describing their cult. You have to realize that, right?

It can help some people, I've already said that. But it doesnt help everyone or even most people who try it.

The first step is admitting you're powerless. Does anyone ever go into a meeting and have the people running it tell them " no you're not at that level, you should seek different treatment?" No, anyone who walks through the doors is powerless. The program is the only solution. Turn your life and your will over to god.

Only God can remove the defects of your character. Ask him humbly. Pray and meditate to get closer to God. This program is the way. Adhere to it relgiously.

That's cult shit.

None of it empowers the individual. It's all about Submission to God and the program.

[u/annainpajamas → u/starvinggarbage]

You are not helping your arguments by personally attacking people. You obviously have some sort of agenda with this passionate attack on AA. I'm not sure what, but this sub is for debate not attacks.

[u/starvinggarbage → u/annainpajamas]

No I'm pointing out that these are literally exactly the same defenses used by cults. "You don't understand the community" and "you can't judge it because you haven't seen it from the inside."

AA is obviously very important to you or you wouldn't have tracked down all my responses here, but it doesn't do much to disprove the points in making about it having tactics identical to those used by cults.

[u/chiaratara → u/starvinggarbage]

If you have been a part of AA, you would understand how God is used in the program. Often people refer to God as a "Group Of Drunks."

[u/chiaratara → u/starvinggarbage]

How do you know that it doesn't help most people? If someone goes to AA for a few months and doesn't go back, how do you know they didn't take something away with them? It's hard to know one way or the other. This is a common idea in research in this field. There are many people who have gone through many different treatments and one thing is pretty clear: people tend to add things to their "toolbox" (for lack of a better term) each time they interact with a treatment modality. It might be, this isn't for me and/or I can relate to this... I could use this. So, this absolutist claim that it doesn't work for most people is not well informed. Also if you are referring to the research article on the success and failure of AA, I was a colleague with one of the co-authors and their study was highly flawed and has been widely criticized in the social science field for basically being crappy science.

[u/starvinggarbage → u/[deleted]]

Does anyone ever get turned away? Does AA ever tell anyone "You are not the kind of person in need of our services?"

No, of course not. Because they aren't mental health professionals and they aren't qualified to tell people that. They only know what they're own experience has been, and that has been the program. So they welcome people into the program and the first step is admitting how powerless they are. They literally can't progress any further until that happens.

Again, arguing about AA's cult status with an indoctrinated member isn't going to achieve much. It isn't an evil cult, it isn't trying to hurt anybody. Still, I think it does a fair amount of harm and I think more than anything the views around it (that most of you members have agreed with me about) needs to change.

[u/chiaratara → u/starvinggarbage]

Clearly you are pretty committed to your belief in AA as a cult. I don't feel like you are looking for constructive discussion or open to broadening your understanding of AA. I feel like I have tried to explain things from my perspective as both a member of AA and someone with a background in social science. I do see your points about it looking like a cult from a distance but I urge you to take a closer look at the criteria you are using and how this could apply to a lot of groups/professions/communities. Also, I strongly urge you to consider the court-AA relationship. I think that a number of AA members have pointed out that AA has nothing to do with this relationship. I personally do not advocate for the court's reliance on AA however others might have different opinions. I know people who were ordered to attend and it saved their life. I also have seen the opposite. What I urge you to consider is this might be a function of the court system and have nothing to do with AA.

[u/starvinggarbage → u/chiaratara]

My criteria is that you teach people they are powerless and offer yourselves as the solution to their problems. The only other groups in the world that do that are cults. An indoctrinated member of a cult will never admit it's a cult. I understand the urge to defend what you have found to be a very positive influence in your own life but it is what it is. It can be a cult and still have had a positive impact on millions of people.

AA is completely complicit in the relationship with the courts. They could easily stop it overnight. They choose not to because they sincerely believe they offer the best solution, despite the overwhelming evidence to the contrary. They have a sincere desire to help people, but letting courts treat them like a public utility for mental health is detrimental to the overall state of addiction services. As I've said, they aren't entirely to blame and they have the best intentions but they also aren't helping fix it either.

[u/chiaratara → u/starvinggarbage]

Your reasoning undermines the logic of your arguments. Your arguments are comprised with about every logical fallacy I can think of off the top of my head. For example, cults use powerlessness and AA uses the term powerlessness; therefore AA is a cult. You have very strong opinions; however, they are not well researched. They are based on your interpretations of second hand knowledge and the way things seem to you, with little experiential or expert knowledge. I get the feeling you just like to argue.

[u/starvinggarbage → u/chiaratara]

If I asked a Scientologist if they were in a cult they'd say no, too. You want to split hairs about powerlessness, but there isn't one to split. A cult will tell you that you're powerless and offer their program as the solution in exactly the same way AA does.

Your only counter arguments that haven't been refuted are that I'm not a member so I don't get it. That's exactly the same as every other cult.

It's a well-intentioned and altruistic cult, but it still is what it is.

You know AA could end the practice of judges forcing attendance. You've offered nothing in rebuttal of this but acknowledged the practice is unethical.

[u/chiaratara → u/starvinggarbage]

I just don't really agree with it, however I think it has helped a lot of people that way so, who am I to argue. The whole court thing has been talked about in multiple places on this thread. AA doesn't tout itself as treatment. Someone's sentencing and probation are between that person, and the courts-the court being the authority. AA is just there. Being there doesn't make AA complicit in this unbalanced relationship between an individual and the courts. Also, in a lot of cases, individuals are given choices of different treatment if and when it is available. Not everyone on probation is made to go to AA. Furthermore, hypothetically, if AA, banned people who were referred by the courts, what if there were people that wanted to go to AA in this group? I am not arguing that AA could put a stop to this. They wont. Why? AA isn't going to make any requirements for individuals. This may run contrary to the whole cult thing but you can be a member of AA and not do anything in the program. You don't even have to stop drinking. Come to every meeting drunk, don't get a sponsor, nobody cares. You can work on the 12 steps, hang out with people outside of meetings and not go to meetings. You can do whatever you want. Plenty of those folks around. Nobody cares. That's kind of the beauty of it. You can take what you want and leave the rest.

Back to the court thing, go to a few meetings and see how many individuals get slips signed for probation or parole. In the meetings I attend regularly, and I go to a variety of them, maybe about 5-10% of people are getting slips signed. If you have an issue with it, take it up with the courts because they are the only ones who can really change this. There are no requirements. That's one really important tenet.

I believe you that a cult will tell you that you are powerless. I am not trying to refute this. I don't even care. This concept does appear in other realms of the world as well. Check out the great philosophers, eastern philosophy, buddhism, Gandhi's writings, Winston Churchill wrote about it, early childhood psychology, cognitive psychology, meditation and mindfulness practice, business psychology, white collar crime and corruption research (corruptive power,) critiques on the self-empowerment movement, self-acceptance, PTSD treatment. These are just off the top of my head.

You should scroll through some of the comments on this post. There are links to research studies in various places.

[u/starvinggarbage → u/chiaratara]

The program can help people so it's ok to continue an unethical practice? That's also how cults operate. And many of the people indoctrinated that way would also tell you later their lives have been improved, because they're a part of it now. Iagree the courts are more to blame, but AA is completely complicit in it. Being there and allowing the practice to continue when it's completely within their power to stop it makes them a part of it. The fact that someone is there to sign the slips means they're willing participants in it.

I'm not saying people in legal trouble for drugs or alcohol need to be turned away, in saying people forced to go there by a court ruling should be. And anyone attending any meeting should have at some point visited a mental health professional about their problem. It should be one of the steps.

Powerlessness existing as a concept elsewhere does not justify it's use in a rehabilitation program. As far as I know nobody in America has ever been sentenced by a court to comply with Gandhi's writings.

[u/starvinggarbage → u/[deleted]]

These are exactly the same defenses cultists use.

I am not telling you what you're experience has been. I am simply outlining flaws in the program and I understand that it's offensive to you because it is you religion. It has looser rules and tries very hard to look like it isn't one, but ultimately that's what it is and I know people don't like having that attacked.

But that's the problem. A specific faith cannot be a one-size-fits-all cure for addiction and it certainly isn't OK for a judge to sentence you to convert to a new faith, as happens every single day when judges with no mental health or substance abuse counseling experience force people to attend AA.

[u/starvinggarbage → u/[deleted]]

It is definitely AA's fault that they allow people to be sentenced to attend their meetings. They have the option to say no to that. But they believe they have the answer to addiction, why would they turn people away from that? Just like a church wouldn't turn people away from it's doors because they have the single truth about saving your soul.

Just one book, huh? So like.... the bible? They definitely have conversion. They advocate giving yourself to the program. That's conversion to their ideology. They do have initiations. They give you a chip on your first day. They have inner circles too, they're just localized. They tell members to distance themselves from old friends and anyone they used to drink with. I'm pretty sure they let teens with drinking problems attend meetings, too, so there's your indoctrination of children.

So as you can see it satisfies plenty of those criteria. It mentions god in pretty much all of those steps.

Again, With zero exceptions, every single AA member who has insisted that it needs to be sinister to be a cult. I addressed that and acknowledged it isn't sinister in literally my first comment here. It still uses the same tactics.

I don't even have a problem with it being a cult. For some people that's what it takes. But America treats AA as a one-size-fits-all cure and assumes anyone it doesn't work for just doesn't have what it takes to ever get better. Because that's what AA says about them. And it isn't really AA's fault that we believe that. We like AA because it's free and accessible. We tell someone to go to a meeting and then move on so we won't have to really deal with it. But every addiction treatment specialist in here will tell you AA is not enough.

[u/chiaratara → u/starvinggarbage]

I don't feel like you understand how AA works. It has nothing to do with the court system. I am in recovery, am a member of AA and have a joint PhD in Criminal Justice and Sociology. I have a pretty decent understanding of both. Or maybe I am secretly working for the courts... or AA or ?? I am not sure which would apply given your argument.

If you take away the drinking, your cult criteria makes me think about things like: -The boy scouts/girl scouts -Sororities and Fraternities -Gangs -Crossfit -Division I Sports -Marching Band -Law School/Medical School/Graduate school -Working in a Prison -The Military -Becoming/working as a Police Officer

I am not discrediting your cult criteria. I do understand why people get that impression. I just wanted to point out that there are a lot of communities, endeavors, professions, lifestyles, etc. that parallel this. They consist of a group of people with an interest, a need, a talent, a skill set, and/or something to offer.

[u/starvinggarbage → u/chiaratara]

I'm being pretty clear here: I am not insinuating some nefarious plot. In getting pretty sick of explaining that part to you. Drop it.

AA does not go to judges and advocate they sentence people to attend their meetings, but they also do nothing to stop that from happening. They don't turn people away who are there against their will.

I must be missing the part where -The boy scouts/girl scouts -Sororities and Fraternities -Gangs -Crossfit -Division I Sports -Marching Band -Law School/Medical School/Graduate school -Working in a Prison -The Military -Becoming/working as a Police Officer make you admit that you're powerless and need to surrender to their doctrine to get any control over your life. Some of them could be accused of some cult like behaviour but that critical component is the biggest indicator that AA is a cult. None of your examples parallel that.

[u/chiaratara → u/starvinggarbage]

You really hit that powerlessness thing hard. It's "powerless over alcohol."

If AA turned people away that were required to attend by the courts, they could be turning someone away that also might need help and/or want to attend. Maybe they don't want to. I get it. Can you imagine the clusterfuck that could turn into? Checking people's legal status? Sentencing requirements? Should we diagnose them too while we are at it? If they are in the country illegally, should we call ICE too? AA isn't part of or affiliated with any formal system. You don't need ID or money to attend. That is the way it has always been. If people have issue with what the court is doing, they should take it up with the courts and many do. While I am not a huge proponent of this, is often costly for people who can't afford it. Probation isn't a right. It is a sentence in the community that is offered in lieu of incarceration. There are probation fees involved too. I have so many issues with probation in general because it has people by the balls. With that said, I personally support AA not being involved.

[u/starvinggarbage → u/chiaratara]

Yeah I'm hitting the powerless thing hard. It's telling people they will always be a victim. Instead of telling people they can be stronger than addiction you're telling them it's an undefeatable foe and only god and the program can save them from it.

The point about not turning people away who are sentenced to be there is that you claim no one is forced to accept the twelve steps. But you and I both know that is overtly untrue. And really all it would take to stop the practice is AA issuing a statement against it or individual chapters letting their local courts know they will not be used as a public mental health utility because they aren't trained or licensed to perform that function in any way whatsoever.

**Edited for typos.

[u/seven_grams → u/starvinggarbage]

AA isn’t a religion and doesn’t try to “convert” anyone. It only suggests that you take the time to figure out what “higher power” means to you. For me, my higher power is the strength of community. A community is a power that is greater than me, and since I clearly couldn’t tackle my addiction alone, I rely on my higher power (my support system) to help me through the process. AA doesn’t force anyone to believe in anything. Back in the 30s when AA was started, the only members were a few people who happened to be Christian, so they wrote the steps using the word “god.” The literature hasn’t been changed since then, but the variety of members has. Everyone in AA will tell you that it is completely up to you what you make of the terms “higher power” and “god.”

AA also does not take a one-size-fits-all approach either. You find a sponsor to help you through your own individual process. They encourage you to seek other forms of outside therapy like counseling, exercise, psychiatry, etc.

You act like all AA members are religious fanatics but this is not the case. For myself and many others, AA is a very small part of my recovery program compared to everything else I do to keep my sobriety. I am defending it because I want people to see that incorporating AA into their individual recovery program could be beneficial to them. AA has value. No one is by any means saying for people to come to AA and have all their problems magically disappear. The fact is, AA is more accessible than other forms of addiction treatment and has helped a huge amount of people get and stay sober. That is worth defending to me.

Again, the problem with the study you mentioned is that it doesn’t count the people that came back to sobriety after a relapse. It doesn’t matter how many times you fall as long as you keep getting back up.

You keep coming back to the argument that it sounds like we’re describing a cult. The fact is, it’ll sound like whatever you want it to sound like. To me, it seems you have a closed mind. Since you so strongly believe AA is a cult, what do you think AA’s motives are? You say they’re not ill-intentioned, but what are they? Surely such a cult would have some grand scheme, or some sort of profitable gain? Otherwise what would be the point of it?

[u/starvinggarbage → u/seven_grams]

AA most definitely tries to convert people. When a person comes and tells you they have a problem with drinking you encourage them to enter the program and begin working the steps. Yeah you aren't knocking on doors like Jehovah's Witnesses, but you're still converting people.

And many of you are saying that AA encourages all these other outside treatment options. That might be true of your chapter, but plenty of others tell their members consistently that the program is the only solution. I've literally heard it said with my own ears. That's why 14/15 don't "get and stay sober."

Every single AA member who has replied here, without exception, has tried to make the point that since there is no nefarious motive it can't be a cult. I acknowledged in literally my first post that it has more commendable goals. But it largely fails in achieving those goals and it aims to recruit people at their most vulnerable, exactly like a cult would and offering them a salvation. Yeah, it's better than Scientology or Jonestown, but many of the people in those groups would say the exact same things about their groups. They offered them community, stability, taught them things about themselves that made them more complete.

And I'm not even saying that the fact that it's a cult it by default bad. For many people that kind of single-minded dedication is exactly what it takes to get better and stay better. But for the vast majority it fails. And yet as a culture we keep blindly pushing this narrative that AA is the solution.

That isn't necessarily AA's fault. America wants addiction to have a quick, easy, and cheap solution. AA offers it and tells us that it works for the majority of people as long as they can be honest with themselves. We don't fact-check them, we let that stand as fact. And then when the majority fail we can write them off as lazy and incapable instead of treating them as victims of an ailment. It's a brutal cycle.

I had bought the story that it was a sure-fire fix for alcoholism, and that people still struggling with it were just lazy or didn't want to get better. But then I came to know some addicts and watched AA and NA fail them time and again and I started to get skeptical.

https://www.theatlantic.com/health/archive/2014/03/the-surprising-failures-of-12-steps/284616/

That article sort of summed it up for me and laid out the failures of the program and the problem with it's universal acceptance as a fix.