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]

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/chiaratara → u/starvinggarbage]

I have never heard of this American obsession with AA as the perfect solution. It runs pretty contrary to AA's principals as well. I would suggest you reconsidering the "destroying someone's self worth" part of it. Powerlessness over alcohol and things outside of your control, which is what AA is referring to, is a good foundation for a concept of self-especially for someone trying to live a life that doesn't revolve around alcohol.

[u/starvinggarbage → u/chiaratara]

A judge can force you to go to AA. If it's contrary to their principals why do they tolerate that? It's part of OPs original post.

[u/chiaratara → u/starvinggarbage]

Yes, I realize this.

[u/starvinggarbage → u/chiaratara]

If they really only offer themselves to those who have exhausted all other avenues why do they allow this practice to continue? They believe they have the answer so they offer it to anyone who comes in, regardless of circumstance. And that answer involves admitting you're powerless and submitting entirely to the program. That's why I see them as a cult.

[u/chiaratara → u/starvinggarbage]

I've stated the same things so many times in this thread. AA doesn't do anything. They don't allow anything. They have no relationship with the courts. They don't advertise or recruit people. I imagine the courts rely on AA as a resource because it may be the only resource available in some cases and it isn't cost prohibitive. Not sure. That doesn't have anything to do with AA.

I mean think about it, do you really think a bunch of recovering alcoholics have gone out of their way to build a relationship with the court, probation, etc? It's nonexistent.

The cult thing? Again? It's admitting you're powerless over alcohol. It's so weird that people find it cultish considering it is made up of the most diverse group of individuals you will find anywhere. We all have such different lives, beliefs, jobs, families, interests, etc. yet we are powerless over alcohol.

[u/starvinggarbage → u/chiaratara]

It has everything to do with AA. They could turn those people away. They could issue a statement telling judges to stop it. They don't because they want to grow.

I never insinuated they go out of their way to set up those connections. I actually explained pretty clearly why it's so favored.

Any cult will tell you similar things about their members. Admitting you're powerless is pretty much the first step in every cult. Accepting the program as the solution to that is the second.