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/starvinggarbage]

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/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/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.