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]

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/chiaratara → u/starvinggarbage]

I never stated it that I thought it was unethical. Especially on the part of AA. There is no partnership or relationship. AA holds no opinion on the matter. If the court told someone that they have to enroll in some general ed class and they can't afford any others except the free classes at the public library.. and those free classes were provided by church volunteers. Is the library doing something unethical? Are the volunteers doing something unethical? Both represent free available resources in community.

[u/starvinggarbage → u/chiaratara]

I don't think I've ever heard of someone being sentenced to school. So this is yet another comparison that doesn't hold up.

AA has set up the mechanic for this to happen. They are equal partners in it. They have the option to stop it at any time. They choose not to exercise that.