Damn, Paul,

You sure do sound different when you write something serious than when you are writing from your creative brain.
Two different people!

It is this “character defect” labelling that creates a negative cycle. I had no idea this jargon was used at AA. I can’t say I understand the entire framework of AA or its members, but am not sure if “shaming” someone into changing has ever really had any lasting effect, except for creating a negative one.

Yes, that was a major point I wanted to make. It’s one thing for laypeople like us not to be aware of the AA “character defect” terminology; it’s an entirely different thing for professionals to either be unaware of, or worse, ignore it. And I think this is a major issue. If all the organizations involved in the treatment of recovering alcoholics subscribe to a disease model, and they all do, then the treatments and support groups to which their members refer patients should obviously be in line with that disease model. However, the exact opposite is the case. Unfortunately, I am well aware that those who refer patients to AA will talk their way around any opposition to it, even if AA negates the very manner in which they define alcoholism. Why AA has become even more untouchable and unquestionable than religion is beyond my understanding. It’s all rather amazing and, for the recovering alcoholic and all those close to him or her, terribly sad.

Paul,
You have got the wrong idea about ‘these defects of character’ in the 6th Step.
There is one word which you have missed. That word is ‘these’. What this means is that as a ‘result’ of the alcoholics drinking he did certain things which he should now address. He makes a list of these things in Step 4. He talks about them in Step 5. And, in Step 6 he is ready to change his behaviour - get rid of ‘these’ defects and begin to be released from the guilt and shame he has built up during his drinking.
Bill W. who wrote much of the AA texts once said that he was taught in school to try not to use the same word in close proximity to each other. Thus in Step 4 there is a ‘moral inventory; in Step 5 there are ‘wrongs’ to talk about; in Step 6 the description is ‘defects of character’; and in Step 7 they are described as ’shortcomings’. To AA’s they all mean the same thing - “I stuffed up and I need to put it right.”
So there is no conflict.
Incidentally, Bill W. shied away from using the word ‘disease’. That was used only by professional people. He preferred to describe alcoholism as a ‘malady’.
Regards
Sparrow

Hey Paul, First quick thing: please check out Gravatar.com to include a picture in your comment section.

Now, questions/comments:
I’m not sure I see a “contradiction” so absolutely as you do. You seem to be saying that the terms “disease” and “character defect” are necessarily incompatible, and that an institution which ascribes to the first cannot agree to the methods of a group which still uses the other. While I agree the term “character defect” is arcane at best and confusing at worst, I don’t see it as a reason for condemning the AA program as a viable treatment. I see what you’re saying linguistically, but I’m not sure I agree with your conclusion.

If we call something a disease it is reclassifying something as a biological defect, yes? We don’t think of diseases as something we are really responsible for. They just happen. But that’s not entirely true. Death is inevitable, but good health is something we can affect. We can reduce the risk of heart disease, cancers, hepatitis, infection, etc. We can exercise and eat right. We have some controls. So, at best, calling something a disease means that we can reduce characteristics to a biological level and study it there.

But what about this term, “character defect?” What is that? This feels like the “who we are.” The girls who sleep with everyone at 13 and yell at their mom’s on talk-shows, they have a character defect. Jeff Skilling, former CEO of Enron, he had a character defect. We think of a character defect as something we can control, something we are responsible for. But can we really control our characters? This is a huge question but the short answer is yes and no (note the similarities to the disease). Can’t you think of some real assholes who probably couldn’t or “wouldn’t” stop being assholes just because you demonstrated that it wasn’t leading to a good life? Is that a disease? Are they responsible?
The trouble is that notions of responsibility, control and simple cause and effect are often blurred. Many things seem, under some light, to be something that we have control over, where all the results seem a matter of choice. On closer inspection, we can find evidence that the cause lies elsewhere. Through a reductive examination, we see nature’s influence, and how that nature was shaped. We appreciate that individuals are physically compelled to behave in such a way, but we cannot completely deny a person’s responsibility for the actions they take without risk of reducing all action to cause and effect. In short, we are left with a melding of perspectives. At the cellular level, a possible hereditary trait which manifests hyper activity of the nucleus accumbens; at the human level, an addict. Being an addict is certainly a part of their character, isn’t it? If not, then what is character?
The medical community uses AA because it has some degree of success, and because it offers the most important aspect of overcoming addiction, immediate and regular support that is completely accessible; but it’s not the only program out there. There are alternatives to AA

On its own website, AA states that alcoholism is a disease: http://www.aa.org/subpage.cfm?page=12

Thus, AA has currently dismissed the statement you quote, which was offered by one of its founders, Bill W.

Further, Step 6 couldn’t be clearer. It’s obvious that “these character defects” (I’ve added “these” to no discernible effect) are such a major part of AA’s thinking that they’re included as one of AA’s mere Twelve Steps. Now, if AA’s method of addressing what it sees as character defects works for some, I have no problem with that. I am not, nor will I, engage in an argument over the validity of AA because it’s akin to arguing religion: neither side will convince the other of anything. Finally, my mission is not to attack AA but rather the incompatibility between the disease concept and the Twelve Steps, the cornerstone of the AA recovery model.

Step 6 could not more clearly be out of line with the disease model. From the Lakeside-Milam Recovery Centers’ come the following comments by Dr. James R. Milam: “This paper describes the polarity and the shift to the new model that is transforming our entire view of alcoholism (and other drug addictions). I have adapted the terms ‘psychogenic’ (of psychological origin) for the old paradigm and ‘biogenic’ (of biological origin) for the new.

“The psychogenic model is based on the nearly universal belief that alcoholism is a symptom or consequence of an underlying character defect, a destructive response to psychological and social problems, a learned behavior. The biogenic model recognizes that alcoholism is a primary addictive response to alcohol in a biologically susceptible drinker, regardless of character and personality. It will help at the outset to realize that compromise is not possible, that the two are not complimentary but mutually exclusive alternatives, like a perceptual figure-ground reversal.” [http://www.lakesidemilam.com/TheAlcoholismRevolution.htm]

Now, I could offer a thousand links indicating that one of the primary motives behind the creation of the disease model was the de-stigmatization of the alcoholic, who would no longer be seen as having “character defects” but rather a disease. Thus, AA’s own site contradicts itself, and so do those treatment professionals who subscribe to both the disease and AA models. AA obviously has developed its approach over a long period of time, considers that approach correct, and is therefore unlikely to make major changes to its approach. Therefore, it’s up to the treatment community to decide whether it wishes to view alcoholism as a disease or the result of “character defects,” or offer an alternative to those choices.

I will agree the issue is incredibly complex. That’s exactly why I find the nearly-universal adoption of AA as the sole path to recovery a bit puzzling and overly simple, especially when those adopting it subscribe to a theory — the disease model — that explicitly denies “character defects” as a cause of alcoholism.

I’m arguing against two points here. One commentator sees no incompatibility between a disease model that rejects the idea of character defects and an organization that has embedded within its primary document the belief in character defects as a cause of alcoholism. The other commentator denies that the 6th step *really* means “character defects” based upon the word “these.”

Both cases are rather simple to address. The “disease model” and “character defects” are absolutely incompatible, if not by AA’s definition, then by the disease model’s definition, or vice versa. One cannot have it both ways. Next, by including the word “these” in quoting the 6th Step, one only adds an unsupported specificity to the term “character defects,” i.e., “these character defects” meaning exactly which character defects? Step 5 does not clarify matters: “Admitted to God, to ourselves and to another human being the exact nature of our wrongs.” A “wrong” an alcoholic commits does not equate a character defect. A drunken alcoholic may commit all kinds of wrongs, but his or her thinking and behavior are rendered irrational by alcohol; that person’s true character has been deactivated. Thus, we are back to “these character effects,” and the language does not require a linguist to parse.

I stand by my statements, though I know they will come under attack due to the fervor with which many AA members support their organization. If it has worked for them, that fervor is understandable. I’m glad it works for such recovering alcoholics. My article is not concerned with AA, per se, but rather the contradiction — which neither comment explained away — between one model that denies “character defects” and another that accepts “character defects” as one of alcoholism’s causal agents. One can “complexify” the issue to infinity, but the division between believing in the “disease model” or “character defects” remains something like believing in God: you do or you don’t, unless a person wants to be agnostic about it, an unlikely motivation for someone to become a substance abuse counselor.

Addendum: There indeed exist alternatives to AA. Of all the times I’ve been seen by therapists, psychologists and psychiatrists, I had to inform them about those alternatives. None seemed especially impressed by the alternatives. I’ve been seen by enough such professionals to extrapolate that this is the norm due to the much greater “fame” of AA.

Great points made here Paul.

I got a DUI in California and had to attend several AA-type meetings. They had three or four alternatives to AA, like Smart Recovery and Rational Recovery. I can’t remember which one I went to, but it was an alternative one, and it was fine, whatever. I tend to binge drink when I do, and that’s what got me the DUI in the first place. I have since lessened my own drinking to fewer and fewer situations, partly because my body simply can’t take it much anymore.

While I think your point is definitely valid and perspicacious, I doubt anyone involved with AA or drinking heavily or even in the medical field even give a damn about the semantics of it. You might be the first to really care, hence the essay, which I found illuminating.

On a side note, I’m not sure how much you read others’ works, but David Foster Wallace’s Infinite Jest goes into incredible exhaustive detail about addiction, specifically following Don Gately, a character who is consumed with going to AA meetings and running a Recovery house. I got so close to that world that I felt like I never really needed to see it firsthand, because I already had. He also delves deeply (somewhere in the book, can’t remember) into the essence of what addiction means, medically-speaking.

Cheers on the essay. I hope it garners some attention by some people in the field who might care enough to consider it.

Paul–as the others have said, very interesting points here. This essay reminded me of something I haven’t thought of in a long time:

Some years ago a work acquaintance was having some severe troubles with alcohol, and was finally told by HR that he needed to begin attending AA or he would be terminated. He flatly refused, on the grounds that, as an atheist, their mandate he attend a religious organization violated his Constitutionally-protected religious freedoms. When they fired him, he sued them for religious discrimination, and won. He told me afterwards he would have been perfectly happy to attend a secular-based treatment program (he was trying to sober up anyways), but none were offered, even after he asked.

Also, have you ever heard Gary Busey wax poetic about the benefits of AA? It’s a lot like listening to Tom Cruise discuss Scientology.

To All:

I will respond at length to some of your posts tomorrow. I was unable to post lengthy comments I had written earlier due to a glitch on my end.

To Matt:

Very interesting. Also of note, the Supreme Court at least once ruled in favor of plaintiff who had been ordered by the court to attend AA. However, the ruling was non-binding and did not set a precedent. However, various courts have ruled that AA is a religious organization and that defendants cannot be forced to attend AA meetings. To me, it’s beyond question that AA is a religious, faith-based organization. However, some atheists find a way around that fact, learning to live with it in exchange for the group support. I understand this thinking when AA works for the atheist or agnostic; however, I’ve attended AA and have always eventually left simply because I could not convince myself of a higher power in any form, and that undercuts the entire program. Nevertheless, I can’t say I gained nothing from it, and I certainly met some intelligent and interesting people. On the other hand, I have also attended meetings in which a subtle pressure to believe or convert, or the suggestion that I would eventually do so if I remained in the program, was palpable.

I don’t think the above negates the following statement: I’m not arguing against AA’s approach or existence. I may not agree with it, but that’s another matter. I’m only concerned with the treatment approach and the inconsistencies mentioned in the article.

It did cross my mind that if AA wanted a still-broader membership, it should consider forming a separate and secular group that would consist of meetings in which alcoholism would be discussed and support shared, without the involvement of religion, higher powers, faith, etc. This could also simply be an addition to the already-varied types of meetings, e.g., speaker meetings, 12 step meetings, etc. Since AA is, as some have noted, by far the most and usually only available support group, why not spread its arms open to nonbelievers? While it claims to do so, AA actually only addresses agnostics in its Big Book (apparently, atheists are “lost souls”), and even though that chapter is often referenced by those trying to convince me that AA is accepting of nonbelievers, the chapter insists that one will, over time, develop belief. Therefore, except for the types of atheists I mentioned, there are few options.

I will post information about AA alternatives and a few books tomorrow. A choice of support groups should be available to alcoholics, but that choice only exists in some towns and cities. For most people, it’s AA or a do-it-yourself project. However, I will provide some resources that may be of assistance to those doing it themselves. And I will also, again, address some of the comments to which I was earlier unable to respond.

Thanks for all the comments, whether pro, con or somewhere in between.

To Richard Cox:

As to your question about AA alternatives, here is some information. I can’t provide links, as doing so seems to cause errors in my posting comment replies. Simply search for the organizations, and you should find them at or near the top of the results.

Organizations:

Rational Recovery: No meetings in the AA sense; see the site for the types of arrangements available. Primarily text-based, but the website includes a an online Crash Course, a link to which you’ll find upon scrolling down the home page.

SMART Recovery: Online support with discussion forums, chat rooms, etc., plus meetings in some towns and cities.

Books:

Rational Recovery: The New Cure for Substance Addiction by Jack Trimpey: The “textbook” of Rational Recovery.

When AA Doesn’t Work For You: Rational Steps to Quitting Alcohol by Albert Ellis: By the founder of Rational Emotive Behavior Therapy, a practical but well-supported psychological theory based on philosophers both ancient and modern. Easy to put into practice, but one must to keep putting it into practice. If taking the Rational Recovery approach, I would definitely use this book in conjunction with the former’s “textbook.” The reverse is not necessarily the case.

How To Control Your Anxiety Before It Controls You by Albert Ellis: Many alcoholics have preexisting anxiety disorders that alcohol worsens. Once recovery occurs, anxiety may persist even for those who had no preexisting anxiety disorder. This book has remarkably reduced my anxiety within weeks and began to work after I had read the first chapter. Again, it must not only be put into practice but kept there. Ellis has other books that apply to almost every emotional issue with which a recovering or still-practicing alcoholic might struggle.

As to the disease model, personally, I do not believe the evidence exists to prove its validity. I prefer the term “syndrome,” or “a group of signs and symptoms that occur together and characterize a particular abnormality or condition” (Mirriam-Webster). Whether or not research will one day support the disease model, I’ve no idea. For now, I am not that concerned with either the current definition or my suggested replacement term. I consider the debate a waste of time and resources that would be better spent on treatment and treatment research.

An alcoholic experiences less choice than an occasional heavy drinker because the body and brain have become so acclimated and dependent upon alcohol that an insufficient quantity, or a quantity absorbed too long after “happy hour,” will cause severe anxiety and other torturous problems, not to mention the very real possibility of a seizure. The intensity of withdrawal cannot be described; it can only truly be understood by experiencing it. As one begins to withdraw, drinking almost becomes rational, except that drinking to relieve withdrawal backfires the next day, when symptoms intensify, and so on. Thus, continued drinking under such circumstances is simultaneously rational and irrational, accounting for the trap in which alcoholics find themselves and the reason why they continue creating the trap in which the alcoholic finds himself. It takes a tremendous amount of strength to stop drinking and undergo detoxification. That’s why treatment consistent with diagnosis and definition is crucial.

Regarding treatment at the cellular level, I doubt it exists now, but I would guess that research is underway. Other new drug therapies are emerging, but I’m not familiar with them yet. When I become so, I will post my thoughts here or on my website, Violent Contradiction: The Paul A. Toth Blog.

Excuse the typos and other errors; I’ve stayed up far too late!

Egad - this started out complex and quickly snowballed into more complexity, and it’s fascinating to me. I think I’m going to have to go back and re-read this (and the comments that follow) to really come to grips with the concepts, and I’m really intrigued by Thomas’s reductionist arguments.

Without having any experience with AA, and being luckily untouched by alcholism in the lives of myself, my friends, and my family, I have heard it said that one of the issues with AA is a certain absolution of responsibility - this post has made me re-consider a lot of my previously-held (and admittedly hazy) considerations.

I think there’s a sense of “fault” or even “character defect” in lots of maladies we define as “diseases.” Lung cancer is a disease, but if the patient was a smoker, society often considers him/her at least partly responsible. And, from experience, I know that anorectics are often accused of “doing it for attention,” in spite of the fact that anorexia is accepted as a disease.

We always seem to want someone to blame.

Blame is the national past-time. My theory proposes that m=sc2, i.e., “Moralizing equals skeletons in the closet squared.”

For those interested in the effectiveness of AA, some statistics exist that may easily be found via web searching. Those statistics are not aplenty, as it’s difficult to study a group that understandably requires, as its name indicates, that everyone remain anonymous.

I won’t go into those statistics or the conclusions I reached, as I don’t want to push aside the purpose of my writing the article and convert the discussion into one about the success or failure of AA as a recovery model. For now, I’ll only state the obvious: AA works for some number of members; others drop out and return or never return; and some never attend a single meeting. Each individual is different and will accept or reject the AA model for reasons of his or her own: one individual will find AA a lifesaver; the next will consider AA of moderate assistance; and a third will repeatedly relapse despite incessantly attending AA meetings. To make things more complex, all of those results have a multitude of possible explanations.

The article’s “target” is not AA but the treatment community and those under its care, so at least the latter will become aware of the discrepancy between how and why they’ve been diagnosed as alcoholics and the contradiction in the recovery approach almost always suggested and often almost imposed upon them by that treatment community. Ultimately, of course, I hope to reach the treatment community. Still, even the strongest and best-supported argument usually fails to cut through long-held ideas and habitual behavior, whether that be the treatment community…or an the alcoholic.

Ultimately, my point is not that the treatment community should never refer patients to AA. Instead, I’m arguing that the treatment community’s doing so is, according to its own definition of alcoholism, contradictory and irrational. And if their definition is correct, then its dangerous, as well.

Finally, whatever its merits, society needs to take a long look at why AA has become so ubiquitous that for those in all but a few cities and towns, absolutely no alternative recovery groups exist. Thus, the alternatives I’ve mentioned, and to which a comment above includes a link, involve reading for most rather than group support, support I would thoroughly endorse if an as-easily-accessible secular alternative, as well as AA, were available. Since diseases often offer a variety of treatments from which a patient chooses, so too should alcoholism and addiction, if considered diseases, offer a variety of options from which to choose. In a response above, I explained one simple way in which this goal could be accomplished with zero federal, state or local government assistance and minimal effort.

Well, Paul, you have obviously touched on a controversial point, judging from this barrage of comments. It is an extraordinary essay, by the way - thought-provoking from a singular point of view. And as such, it makes it clear that a great deal more thought SHOULD be given to the subject.
I don’t want to take anything away from AA. It has clearly helped millions of people deal with their chemical dependencies since its inception and obviously works for a lot of people.
This said, however, the point can be made that while other alternatives exist, they are forced to stand in the shadow of AA. This is not necessarily because they have been proven not to be just as effective as AA (if not more so). Rather, it is because AA has become a worldwide “bestseller”, sort of the Sydney Sheldon of self-help programs for alcoholics. Or perhaps a better metaphor, in terms of the perception of not only the public at large, but also of many in the medical and sociological professionals would be that it has reached the institutional status of the Boy/Girl Scouts in terms of the mass appeal of its profile and the ostensible “rightness” of its methods. What this means is that, in the belief that “you can’t argue with success” or that “certain institutions are of unquestionable repute”, AA has become the sacred benchmark for the prevention and curing of alcoholism.
But seen objectively, while it may clearly be a “silver bullet” for a lot of people in trouble with drink, and maybe even for a majority of people in this situation in a largely “Puritan” America, it must be said that it is not for everyone - and you have said this in no uncertain terms, and terms that I, for one, have never seen elsewhere before.
This is more problematic than it might appear at first glance, since it is not a question of “if you like it, fine, and if not, fine too.” The fact is that if the vast majority of mental health professionals and civil institutions are wont to recommend AA above any other program and are loath to equally recommend others that are just as effective if not more so, then we have to assume that significant numbers of people who voluntarily seek help in AA are driven away by its clearly non-secular peculiarities, as are those who are ordered or strongly urged by the courts or by professionals to seek help specifically with that organization. And since alcoholism (read, chemical dependency) is an illness in which the subjects seldom fully understand why they do what they do and in which it takes an absolutely monumental effort for them to come to terms with the fact that they have a serious problem and need to do something about it, we have to assume that many of those who try AA and fail to get past its “preachy” tone and its guilt-generating facets simply “fall through the cracks” and back into the depths of their illness, ultimately dying of their disease.
The worst part of this is that it apparently hasn’t served to spark the emergence of vastly improved methods within AA itself or within more advanced programs for dealing with chemical dependency from a secular and critically objective stance. Rather, blame falls where it can least afford to be placed: on the addict, who is stigmatized for “failing to respond to AA treatment”.

I’ve made two slight corrections to the article. First, apparently it has only been my experience that *every* AA meeting ends with the Lord’s Prayer. Additionally, I forgot to mention that the Lord’s Prayer was followed by the Serenity Prayer. I’ve been told that this is not the case in every AA meeting; perhaps it’s a Florida practice.

Next, of course no AA member *must* believe the 6th Step, but not believing in the steps and attending AA meetings is akin to an atheist attending church services. Finally, treatment providers should obviously not — though they obviously do — ignore the primary document of the organization to which they refer all their alcoholic patients.

To Dan Newland:

Many thanks. I agree with all of your points. While I assail the treatment community, the alcoholics who do not respond to AA for whatever reasons are the ones to suffer…and they’re already suffering more than most people could bear.

The “bestselling metaphor” is a good one. The absolute “victory” of AA is a phenomena as difficult or even impossible to understand as why one novel goes to the moon, while thousands upon thousands of others may hover over the earth or more likely crash to the ground.

It’s that hyper-prevalence of AA as the sole treatment option (except in a relatively-few areas) that may partially drive the treatment community to rely upon it as the sole recovery method despite the gaping discrepancy between the AA model and the treatment community’s model of alcoholism.

Thus, the development of a secular alternative to AA, without dogma either atheistic or religious, but simply a group that discusses alcoholism without the trappings of religion or any other institution — just simple dialogue — would go a long way in addressing the problems I explained in the article.

Meanwhile, the treatment community needs, but will likely never, reconsider its understanding of AA…or perhaps they don’t understand the exact nature of AA in the first place but simply accept the usual work-around phrases such as, “You can always use the group as your higher power.” Wrong answer.

Ah, AA and alcoholism. I don’t understand the whole situation anymore. I used to, when I was younger, when alcohol obviously = teh badd.

Now? I see way more people addicted to caffeine than alcohol. I see way more people overweight, overworked, and on their ways to earlier graves. I’m certain more people require the eye-opening cup of coffee than the eye-opener drink, and I personally don’t think the effects of alcohol are any worse than the effects of high fructose corn syrup and caffeine.

But then, that doesn’t even get into the legitimacy of the APA and psychiatric disorders. I used to edit The Journal of Psychosocial Nursing and Mental Health Services, a journal dedicated to the practice of psychological nurses usually in clinical settings, and which addressed a wide range of behaviors, mental illnesses, spectrum disorders, and the treatments thereof. We ensured we used person-first terminology (as in, for us, there is no such thing as an alcoholic. We would say people with alcoholism. No schizophrenics, only people with schizophrenia), which I always thought interesting in itself, but I remember one conversation my supervisor and I often had was concerning whether such things disorders existed, and what made some people more susceptible to certain disorders than others. A lot of times, it seemed like symptoms of disorders were a bit like characteristics of a horoscope. Meaning, if you didn’t know it was based on your birthday, one might read all the twelve signs of the Zodiac and think, “Huh, I’ve got characteristics of all these signs. Maybe I’m more than one.” Especially with something like depression; we all feel some of the symptoms of depression–whether acute or not-at-all–at some point.

Try reading the symptoms of borderline personality disorder and actually attempting to make a diagnosis, or even come up with a set of criteria for one. It’s damn near impossible. And when you do come to a diagnosis, which is better: ameliorating symptoms of depression or bipolar disorder, or living life in the haze of antidepressant medication–which, by all accounts, doesn’t actually relieve symptoms of depression so much as equalize mood, which means, sure, you won’t be as sad, but maybe you won’t be able to get as happy, either?

I’ve known people who have credited AA with saving their lives, but I’m rarely sure whether it was the tenets of AA or the support that AA provides. The group structure seems a supportive therapeutic system that allows people to talk openly about their struggles, while at the same time offering encouragement to cope with them; it doesn’t sound terribly far removed from something like cognitive-behavioral therapy.

To Will:

Thanks for your post. Your comments are interesting. I have to take issue, though, with the idea that caffeine is as bad as alcohol; no one ever had a seizure from going “cold turkey” off Diet Coke or coffee, and nobody ever ended up in detox after a caffeine binge.

I do agree that the support element of AA being its strongest component. That’s why I suggest that AA itself simply offer an extra meeting for those who merely want to discuss their recovery and lives, without the rest of the AA philosophy — or any other philosophy or psychology — involved: just plain talk. It need be neither atheist, agnostic, religious, nor spiritual. People would be free to discuss those issues, but those issues wouldn’t be part of the organization’s agenda or proposed recovery method. There would be no agenda. Just talk.

Finally, I can’t disagree more that AA isn’t “terribly removed from something like cognitive-behavioral therapy.” The latter is completely rational, though I don’t necessarily agree with it as a strong enough weapon against alcoholism; to me, it’s more suited to minor problems, but that’s just my opinion. AA, on the other hand, requires faith in something, anything, just one thing a person can call a higher power. Many, it’s true, don’t choose God but something else. In any event, a higher power and AA still require faith, which by self-definition is not a question of rationality; it’s a leap of faith, as the faithful themselves say. Something like Albert Ellis’ Rational Emotive Behavior Therapy, an offshoot of cognitive-behavioral therapy, and an improvement over it, is 100 percent rational. It does nothing more than teach people how to think, something most alcoholics either never learned or “unlearned” during their years of drinking. Ellis addresses many issues in his prolific writings, including alcoholism, as well as factors that contribute or result from alcoholism, such as anxiety, depression, etc. AA completely rejects the notion that the alcoholic can think his or her way out of alcoholism; Ellis disagrees. I leave it to the particular alcoholic to decide. I have my opinions, but I’m not going to post them here because, again, I’m doing everything I can to keep the focus on the specific issue my article addresses and to avoid this string of comments from devolving into a flame war about whether the AA approach is valid or not. That’s beside the point of my article, and such arguments do nothing but create friction, hostility and division, without solving problems or convincing anyone of anything.

So, to repeat, the argument my article presents for consideration is that a glaring contradiction exists between how the treatment community defines alcoholism and its almost-universal treatment of recovering patients by referring them to AA. My problem is NOT with AA; it’s with the fact that the treatment community’s definition of alcoholism rejects the notion of character defects as a causal agent in the development of alcoholism, while the almost-sole recovery model upon which it depends embraces character defects as the essence of the alcoholic’s addiction. That’s not unlike diagnosing someone with cancer, telling them that of course it’s not their fault, then sending them to a new age therapist who believes all diseases are the result of a person’s metaphysical disconnection…a character defect. This contradiction needs to be addressed or, as I stated in the article, the treatment community is engaged in malpractice, as I see it.

I will preface this all by saying that I didn’t read all the comments, and much of this has likely already been said. Nevertheless, here’s my take:

As a person who grew up in a home where AA was a fact of life (my father sobered up appx. 1 year before I was born), I feel at least a little qualified to say that I don’t think the 6th step is about character defects so much as it is about, well, God, yes. To a degree. But also, one very common thread among addicts and especially those who abuse alcohol is, ironically, near-pathological perfectionism and a need for control.

Alcohol is something they find, or that finds them, that relieves them of these anxious feelings, not by giving them control or perfection, but by making them not care so much about it–making them forget this self-inflicted responsibility to make everything in their lives just so. Of course, eventually that person is going to sober up, at least in the early going, and find that the mistakes they’ve made while drunk are just more things to feel anxious about, out of control of, and the only way they can escape that feeling is to drink again.

So, while alcoholism might not be a character flaw in and of itself, it can stem from character flaws. And their status as flaws would not have to rely on outsiders’ declaration of them as such so much as they would be evident in the alcoholic individual’s reaction to them. They are something to be escaped from, even at the expense of other valuable things in a person’s life. Like a lot of mental illnesses or “disorders,” one of the primary diagnostic questions is, “does this array of symptoms make the person’s life unmanageable?” That’s what makes it a flaw, or a problem, or maladaptive, or a no-good-thing. In the case of personality traits that foster alcoholism, there’s a consequence that makes a person’s life unmanageable.

It is a psychological “flaw,” for all intents and purposes. After all, alcoholism is a disease, in many respects, but then again, it is not like the flu or cancer or typical diseases and it can’t be regarded in exactly the same way. It is involuntary to a point, but you don’t really contract it involuntary. You USE alcohol for something, and then at some point you can’t do without it. So the flaws are whatever you’re using it for. And they are flaws because they hurt the drinker. Not because they have offended anyone else. They are flaws because they have encouraged the drinker to become an alcoholic.

So that step isn’t about alcoholism itself being a character flaw but finding another way to relieve oneself of the incredible burdens associated with feeling constantly self-critical, dealing poorly with failure, characterizing things as failures that are not failures, and so on. “Let go, let God,” is a way to let go and care a little less about and feel less responsible for every trifling little thing that happens in the world–without getting drunk.

And AAers are quick to point out that “God,” in this day and age, is whatever you want him to be. A Christian God is easiest for most people in a predominantly Christian society, and the notion of having a greater power is so important to the “let go” aspect of alcohol recovery that a total secularization of the process would probably render it useless. I mean, you don’t like the idea of a higher power, don’t join AA. But I feel like the serenity prayer, especially (except for the technical use of the word “God”) strikes me as just plain old good advice, for the most part. You have to pretty nitpicky to object to its use strictly on the grounds that it contains the word “God.”

All that said, I don’t think changing the wording of the sixth step would do much good in combating relapse.

Alcoholics and drug addicts relapse because they are addicts. And AA remains, I believe, the most effective long-term strategy for long-term sobriety that exists. Some people don’t need it. Most people should probably try it if they want to stay sober in the long-term.

To Becky:

Thanks for the comments. As mentioned in my replies to others’ comments that you understandably haven’t had time to read, I’ve stated that I’m not going to discuss, and will discourage debate about, whether AA “works” or not. Therefore, I cannot address many of your points without myself beginning the debate I want to avoid, one that’s beside the point of the article.

Since I’m an alcoholic, I’m familiar with the ways in which one uses alcohol to medicate away anxiety, depression, etc., as well as to forget what one doesn’t want to remember. These and other factors you mention are either emotional disorders that preexisted alcoholism or emotional disorders that resulted from alcoholism.

Why anyone becomes an alcoholic remains and may always remain a mystery, even though a genetic propensity to one’s becoming an alcoholic has been shown to exist. Despite that fact, I suspect a large proportion of alcoholics do not possess this genetic propensity. That’s another debate but one to which research currently provides no answer; therefore, it’s a useless debate.

Without attacking AA, if Step 6 means what you state in your lengthy post explaining it, then Step 6 should be more-clearly stated. For instance, “God, remove the burdens from me that led to my drinking.” However, given that only twelve steps were written, it can only be assumed that those words were chosen very carefully, and that the words mean what they mean. Thus, God must remove a character defect, which could be interpreted to mean a “sinful nature.” Either way, those are the words, and the implication is clear: I, as an alcoholic, have character defects, according to AA. Now, one can accept or ignore this notion and still attend AA. However, the notion exists and runs throughout the AA philosophy.

The point, again, is not to attack AA but rather to indicate that the treatment industry views alcoholism as a disease. So does AA, but its primary document rejects the disease model. AA is clearly a road to redemption model, Christian or not, and one followed by many people of every religion and no religion. I know some of these people find that AA helps them achieve lasting sobriety. I am not going to begin quoting statistics or anything else to prove one way or the other AA’s effectiveness. Rather, the treatment industry needs to reevaluate its own thinking regarding alcoholism. Either it’s a disease without character defects, or, as AA sees it, a disease that resulted from and/or created character defects. These two approaches are in direct conflict. That conflict is irresolvable.

At the very least, the treatment community should inform those whom it refers to AA that AA does not adhere to the accepted psychological, psychiatric and medical definition or model of alcoholism.

In a better world, alternatives would exist. As I’ve stated several times, AA itself could create a second group in which people simply discuss their recovery, lives, etc., with no theory, religion, philosophy, psychology, or anything else involved: just a room and just plain talk, without prayers, without structure, except some kind of time limit, of course.

Currently, in most areas, AA is the only recovery group option. This is unfortunate. There should at least exist one alternative. Alcoholics should have choices, just as most patients who suffer from other diseases or syndromes (I prefer “syndrome” to “disease,” as I don’t think the criteria necessary regarding alcoholism being a disease by definition has yet been proven) almost always have choices.

I’m glad AA works for many recovering alcoholics. I have heard of and read about many different ways of understanding AA; it seems a very individual process (and I have attended AA meetings). Still, even granting your argument that the 6th Step means something other than what its words indicate, AA’s approach clearly implies that the alcoholic requires help from God or a higher power to remove *something* in the mind or soul, call it what you will, that created and/or continues to create the presence of a disease: either one has character defects and becomes an alcoholic, or one develops character defects that maintain alcoholism. Either way, “defects in character” were the words carefully chosen for Step 6 and, by themselves and also considering much of AA’s overall philosophy, the AA model negates the treatment community’s very definition of alcoholism, or vice versa. That was the point of the article.

Best of luck.

Paul (let’s see if I can entice you…despite your disclaimer):

I think I see what you’re saying. I read that article that you quoted from and given strict definitions of psychogenic and biogenic models, the two are certainly incompatible.

My approach was, as it always is, from my layman’s perspective of the terms, and not from a historical or academic approach.

“Character” is a tough thing to define, and I agree that it is inappropriate given its wide berth for interpretation, ranging from objective-moral implications. I see character as a loose mixture of desire, intention, and action. As such, I see alcoholism as a disease (biogenic) which affects one’s character. For me, then, a character defect, in the case of alcoholism, is the manifestation of the disease from the highest perspective.

I don’t like the sound of the 6th step, either. But, under my definitions, it is valid, following this form:

-Alcoholism is a disease, caused by biology.
-Alcoholism affects the part of our character which makes decisions.
-Since this disease has rendered us not powerful enough to control ourselves (make/follow-through-with decisions) something more Powerful than us (step 2) will be needed.
-AA calls that power God
- We are ready for that Power (god in AA’s words) to remove this defect of Character (our inability to make/follow-though-with decisions)

So, under my reductionist understanding of the term “character defect,” I find it compatible with the disease model.

Having said all of that, I totally agree that it’s an awful lot of interpretation to get to an understanding, and there is more room for falling into a psychogenic view of the problem than not, leading me to agree that the term is pretty obsolete. (Unless, of course, all AA members take a semester of Philosophy and Logic as part of their program.)

Ps… Don’t forget to check out Gravatar.com The general theme seems to be a photo which personifies “writer-sexy,” a look which requires dark lighting and a subtle angle of the head measuring no greater than 13 degrees to the right or left.

I wrestled with many of these issues when I quit drinking in 1988, I didn’t like AA, the group I went to was God heavy, I certainly did not believe in God and I thought, is this a better life than drinking all the time? After all the arguments, the fights and disgust, I finally made a few friends in recovery who knew what I was going through. I spent a lot of time worrying about the technicalities of AA when it boiled down to this, either I am going to keep drinking and die or stop and live. The thing is, only addicts understand other addicts. But one point that is seldom mentioned is that addicts in AA are sick, which is to say, I often saw people quit drinking to develop some other budding mental health problem. Alcoholism in my experience is a tight intertwining of the physical and mental and man, after years of drinking, the mental part is way screwed up. Conclusion? There ain’t no easy way out! AA did help me get back on track, much as I resisted. I took what I needed and left the rest behind. But that’s just me.

I’ve some time added to my schedule, so I’ll try my best to reply when I can.

David, what you describe makes sense to me. I know many like you who took what they “needed and left the rest behind.” And AA worked for most of them. Others, however, don’t find the approach so helpful, and their reasons to me don’t matter. Unless they’re willing to accept the AA process, much less some of what you left behind, they’ve no alternatives. That’s my main concern beyond what I mentioned in the article. Some may simply be adverse to groups. Some of those people might have anxiety issues that lead to their avoiding groups. The reasons for avoiding AA, and for attending AA, are endless and complex. In some cases, refusal to attend AA might indicate a denial of alcoholism, but this assumption is, in my experience, too often made in every single case by the treatment community, which largely and truly believes AA is the *only* way to stop drinking. That cannot possibly be true; otherwise, until the advent of AA in the early part of the 20th century, no one in history would have ever successfully stopped drinking. Obviously, many succeeded in doing so.

Therefore, I’m not at all attacking AA; I’m simply making a strong case that it should not be the sole option. Options do exist in a very few localities, plus Internet groups and books, but those to me are not as effective as the support of a discussion group intended for those who prefer another approach than that of AA: simple discussion, without ritual, prayer, documents, steps, etc…in other words, pure dialogue and nothing that some must leave behind in order to benefit from the experience.

It also crossed my mind that there would not be too much of a problem were the treatment community to suggest, “Why don’t you give an AA meeting or two a try. If you don’t care for its approach, we’ll discuss it next time, and I’ll offer some alternatives.” That would be more reasonable.

Nevertheless, the contradiction the article addresses would still exist, and nothing above has done anything more than spend paragraph after paragraph redefining what the obviously-carefully phrased Step 6 states.

Best wishes,

Paul

Well, in the twelve short steps of AA, the wording was obviously chosen quite carefully, so if those who composed what they wrote in the 6th Step meant what its members prefer to believe they meant, they would have written it that way. By the way, Bill W. didn’t agree that alcoholism is a disease, even though AA now says it is a disease. So, in that way, I suppose a person has no idea what the hell AA means and doesn’t mean, so anything goes. It is a disease and it isn’t a disease; people have character defects, but they don’t have character defects. Whatever works for others is fine with me, but if they believe they’ve negated my argument, they’ve only negated what the 12 steps of their own program clearly state. Interpret Step 6 and the other eleven steps anyway you like; the fact remains that in doing so, one no longer is placing faith in the step’s original meaning, which is so short and clear that a mentally-impaired person could understand it: character defects exist which God must remove. Take away the God aspect, and you still have character defects. Now, if that’s arguable, it’s only arguable through an absolute lack of knowledge and/or an ability to read whatever one wants to believe into the clearly stated Step 6. I can only imagine, if a god existed, how that god would feel about the Ten Commandments (he forgot two) being twisted around until they meant anything a person or persons wanted them to mean. “Thou shalt not kill” is no less a clear statement beyond interpretation as Step 6, but a killer will talk his way around that, too, once he turns Christian on death row.

I worded that sentence carefully, subtracting “God” so that only “character defects” remain; I don’t care about the God issue. I don’t care what AA’s members understand Step 6 to mean.

The simplicity of Step 6, even if everyone in AA agrees it’s more or less complicated than I think, summarizes in plain English — for the assistance of the learning-impaired segment of the treatment community — one of many aspects of AA that place the onus of alcoholism on the alcoholic but then transfers that onus to “God” or a “higher power.”

You see, I have no particular problem with that. I don’t even know why AA members or family of AA members feel the need to comment. I am not addressing AA members. I am not telling them what to think. I am not telling them their interpretations are incorrect. My argument is not addressing the philosophy of AA; it’s addressing the philosophy of the treatment community. That philosophy is self-contradictory. My article focuses on Step 6 because it clearly states a position of AA that runs throughout its “traditions.” It is not only Step 6 but almost all of AA that contradicts the treatment community’s understanding of alcoholism. That is not my interpretation; that is a fact. I focused on Step 6 because I do not currently have time to write a book (but thanks for the idea).

Further, some have supported AA *and* the notion that alcoholics have absolute control over whether or not they drink, an equally-contradictory stance. AA itself states in its first three steps: “We admitted we were powerless over our addiction - 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 understood God.”

Therefore, the alcoholic has shifted the burden onto “God” or a “higher power.” I understand this lifts the burden for some and allows for growth. It is not my point to argue against that understanding.

I am addressing contradictory thinking, NOT amongst AA members and AA itself but the treatment community and the treatment community alone. My argument is not weakened by my focus because, as we have seen, Step 6, so brief and to the point, has on this page alone generated thousands of words explaining what it “really” means. If I ran an organization with tenets so open to question and interpretation, I would throw them in the trash. No human resources’ department would intentionally construct such a vague instruction.

There’s no getting around it: The Twelve Steps clearly imply that the alcoholic has a “sinful” nature that can only be redeemed by God. Now that may be of tremendous help to some alcoholics, but it’s not medicine, it’s not psychology, and it in no way suggests a disease, which the main website of AA clearly states alcoholism to be.

A disease, as defined by Mirriam-Webster, is a “CONDITION of the living animal or plant BODY or of ONE OF ITS PARTS that impairs normal functioning and is typically manifested by distinguishing signs and symptoms.” Therefore, if AA, AND the treatment community, consider alcoholism to be a disease, then evidence should be visible in the body and/or blood. Signs and symptoms do not indicate a disease. Anxiety can take the form of many APPARENT medical conditions, known as somatic conditions. We can all agree the signs and symptoms of alcoholism exist; however, signs and symptoms also exist for every psychological disorder so far identified.

So far as I’m concerned, AA can do whatever it wants. But if the treatment community wants to choose an inaccurate definition, and then violate that definition by referring patients solely to AA, which obviously views alcoholism as a “sin” or some kind of “secular sin” that can be exorcised only through AA attendance, then, yes, that amounts to malpractice, though I would much prefer the treatment community to educate itself regarding alternatives to AA, the actual definition of the term “disease,” and what AA proscribes throughout its philosophy and literature, not just the 6th Step.

You make a common error, Paul, conflating the disease of the alcoholic with the actions of the alcoholic. The alcoholic is not responsible for being an alcoholic, as alcoholism is a disease. However, he is responsible for his actions. It is this responsibility for his actions that the Sixth Step is addressing, not the alcoholism itself. Even after completing the Sixth Step–and all twelve of the steps–the alcoholic is still an alcoholic, after all, albeit with a stronger chance of remaining a sober one.

In other words, the alcoholic is not responsible for having a disease. But he is responsible for everything that he does. The words “character defects” in the Sixth Step refer to his actions and his character, not to the underlying disease. There is therefore no contradiction in the AA program.

I hope this helps!

Let me expand on this by means of an example.

Let’s say that a person contracts AIDS through no fault of his own, either being born with it or getting it through a blood transfusion. That person has an incurable disease.

Now let’s say that this person, knowing he has AIDS, goes around being selfish and irresponsible, lying to his sexual partners about it, practicing unsafe sex, and infecting others.

That person can never be cured of AIDS, but the principle of Step Six could change his behavior so that he is no longer a selfish, irresponsible liar, going around doing damage to society.

The situation with alcoholism and AA is much the same.

Alcoholism is an incurable disease, like AIDS. AA does not claim to cure alcoholism; thus AA is not, as you and others incorrectly assume, a treatment for alcoholism. AA says that an alcoholic is always an alcoholic–once you have the disease you’re stuck for it forever, even if you are 50 years sober.

What AA tries to do instead, then, is modify behavior. NONE of the steps actually addresses the DISEASE of alcoholism; all of them attempt to modify BEHAVIOR in one way or another.

This behavioral modification is a gradual process–a fact which, in itself, is one of many program features that begin to break down the black-and-white worldview of many alcoholics.

I really think you are conflating two things–a disease which AA does not claim to cure, and behaviors which AA does claim can be modified. AA is about helping people change their behaviors, not about curing their underlying alcoholism.

I have 24 years without a drink. I am STILL an uncured alcoholic. But my behavior has been modified tremendously, and continues to be modified one day at a time.

No, I disagree. If a disease causes alcoholism, then a disease is causing the the irrational thinking and behavior of the alcoholic. To say the alcoholic is responsible for a disease that causes his actions is like saying a Tourette sufferer is responsible for shouting obscenities in public. There is of course some degree of choice, but that choice diminishes as alcoholism progresses. Can you agree with that fact? I do, because I’ve been there. And most alcoholics remain irrational in their thinking after they quit drinking; that’s why they relapse, not because of character defects. Their choices are hampered not by a disease, or a character defect, but irrational thinking that either developed as a result of drinking or which never existed in the first place. Correcting that irrational thinking is the solution. Then the alcoholic can be truly responsible. To conclude, I must again clarify that I’M not claiming alcoholism is a disease; the treatment community considers it a disease, but of a different order than you and AA describe. AA’s message interpretation, and its members interpretation of AA’s interpretation, is all well and good as far as I’m concerned, but the definition used by the treatment community simply denies character defects as causal agents in the development of AA.

That, as I’ve repeated and repeated and repeated and repeated, is my point.

I think the confusion lies with yourself and your many cohorts in the posts above, as all of you seem to think I’m pointing out contradictions in AA (which do exist, but that’s not my interest); I’m addressing contradictions in the treatment community’s approach to alcoholism.

AA members, take a deep breath, or an inventory, and relax. AA is not going anywhere. There’s no need to be so defensive about it; AA already has a stranglehold on the treatment community to the point that the community rarely realizes alternatives do exist.

Sometimes the overabundance of confidence in the faith approach of AA surpasses that of religious fundamentalism. I don’t know what causes this reaction, beyond the inability of many AA members’ failure to recognize the article attacks the treatment community and NOT AA. No matter how many times I state that I’m glad for anyone whom AA helps, I am repeatedly provided yet another interpretation of what AA and its 12 Steps “really” mean.

And while AA helps many, I also understand the needs of those it doesn’t help. Whether you and your friends agree or not, such people do exist, and AA will never reach them, not because they’re all “in denial” but because, believe it or not, some actually don’t agree with the AA philosophy and abstain without any greater difficulty than any AA member experiences. But this is not good enough. It MUST be true that ONLY AA works and that everyone who fails to recognize this will DIE or go INSANE and is IN DENIAL. Only those who believe exactly that and nothing less will escape the wrath of an AA member on defensive…or is offensive? I can’t always tell.

Whatever works, works, in my view, but that’s not good enough for AA, which has apparently reached the untouchable status of religion. It’s not the existence of AA, or that many agree with what it claims, or bend what it claims until it matches what they prefer it to mean, that irks me. It’s the idea that no one else can possibly be right, an absolute certainty, which are the hallmarks, I’m afraid, of cult members.

As to your additional AIDS analogy, people with AIDS are not rendered irrational by their disease. And AIDS is, unlike alcoholism, an obviously-provable disease. Its presence can be detected in the blood. However, I would guarantee that most of those acting so irresponsibly are also substance abusers, and the reason they’re acting irrationally is the result of substance abuse…a symptom, not a disease. Their disease is AIDS. They also have an emotional disorder or syndrome otherwise known as alcoholism/addiction. Those who don’t have substance abuse issues, and are not suffering from dementia or some other AIDS-related illness, obviously bear absolute responsibility for their actions. On the other hand, spinoffs of AA would claim they’re sex addicts, so we’re right back where we started.

Well, with all due respect, I don’t think you can say you’re not taking issue with AA, when you spend so much time taking issue with AA.

A couple of things you’ve said have really got my interest, because they involve matters I’ve thought of for a long time.

You said “I could not convince myself of a higher power in any form.” I wonder how you can really mean that, if you think about it. Because what a statement like that says–and I have no idea if, with your careful attention to language, you really mean this–is that you consider yourself to be the most powerful entity in the universe. This is, of course, “classic alcoholic thinking.”

Obviously, things that are more powerful than you certainly exist. That is a rational observation, not a leap of faith.

I live a couple of minutes from the beach. I go down there and look at the waves. They are clearly more powerful than I am. Any number of natural phenomena are more powerful than I am. Contrary to what you say, this is not a “leap of faith”–this is a completely reasonable conclusion.

AA is based on reason and what is empirical, not on faith.

It is just as rational to observe that a practicing alcoholic already has a higher power–alcohol. AA is not asking the alcoholic to FIND a higher power, but simply to CHANGE higher powers. This is a simple psychological transference that anybody who has willingness is capable of doing. Even a completely uneducated person can do it.

Alcohol is no longer my higher power. This year its the waves at the beach. Next year it will be something else. I’ve had a couple of dozen higher powers, and guess what, all of them have kept me sober, and not a single one of them has been religious in nature.

In my 24 years in AA, I have never had the “leap of faith” that you posit. Blind faith is an alien notion to me. My “faith,” if you will, is rational and empirical only, based only on the fact that working the AA program has worked for me in the past. I wouldn’t believe in it otherwise. I don’t think any alcoholic worth his salt would, as we are natural skeptics–as you are demonstrating here.

You say that there are people for whom AA doesn’t work. Now I’m going to throw one of those hated slogans at you, lol–Did those people work for AA? Because AA isn’t for those who need it. It isn’t for those who want it. It isn’t for those who’ve been sent there against their wills. It isn’t for those who want to be there. It’s only for those who work it.

But in the final analysis, it doesn’t really matter what the AA program contains. If we sat there for an hour playing tiddlywinks and were able to stay sober that way, then that is what we would do. If jumping jacks worked, we would do that. Why does the rest of the world care what we’re doing in there?

The only thing the outside world owes us is gratitude, because we were sitting in our meetings doing something that you regard as irrational and stupid, instead of getting in our cars drunk and killing your loved ones.

Thus, my practice of Step Six may have saved the life of your loved one, whom I haven’t killed with my car. I think that fact trumps any argument against it.

One of the prime motivators for my posting here is that, after 24 years in AA, I don’t recognize the fellowship (not “organization”) as it is being described here. It strikes me as a straw man argument.

I’m going to knock these inaccuracies down one by one.

AA doesn’t claim, and has never claimed, to be the only route to sobriety. AA literature is clear on this.

AA is not a religion. A religion has a set dogma about a higher power, whereas AA allows you to select a higher power of your own understanding. This can be a non-spiritual higher power if you choose.

AA is not a cult, since it has no leader, no property, no organizational structure, etc.

A person who has done nothing but go to meetings–even for extended periods of time–has not “tried” AA. Sobriety is like any other goal in life–you have to work for it. Those who do not work for it will be unable to sustain it. This is going to be true in ANY recovery program, not just AA. So when somebody tells you that AA did not work for him, ask him if he worked for AA. Did he drive people to meetings, did he buy birthday cakes and served them to street drunks at a meeting downtown, did he set up chairs, did he set out literature, did he do any of the many service jobs available in AA? Sobriety is an activity, not a condition. Some drunk who shows up at meetings, doesn’t like what he hears, and hasn’t done any work in the program, has not in fact tried AA. AA is a job, but one that takes up a fraction of the time of drinking and its consequences.

More specifically, I feel that I have been mischaracterized personally. I am not a Christian, and I doubt that anyone could loathe religion, and Christianity specifically, as much as I do. I think people who are not familiar with what the concept of a “higher power” really means in recovery just insert into this term their views about Judeo-Christianity. Believe me, if that was what was required, I would have died drunk a long time ago.

In AA, all ideas about a “higher power” are respected. Each person gets to figure out his own, no matter what anybody tells you. This is hardly “religious fundamentalism.” This is the exact opposite. This is tolerance and acceptance of all views.

It is also false that AA compels anybody to become a “member.” In the first place, we are not an organization, but an informal fellowship, and “the only requirement for membership is a desire to stop drinking.” We have no power to compel anyone to “join” us. True, the courts often send people to us, but that is not by our design. Ours is designed as a program of “attraction, not promotion.”

Thus, the argument that AA doesn’t “reach” everyone is immaterial, because it is not the job of AA to reach anybody. According to our traditions, people who hit bottom must find AA on their own.

AA is not out to take over the world, to achieve the perfection of its “members,” to promote a religion, to solve the spiritual questions of the universe, to change society, or any of the other motivations that have been falsely ascribed here. The AA Traditions are clear: “Our primary purpose is to stay sober and to help other alcoholics achieve sobriety.” Period.

At most meetings we say “We are not saints.” Our purpose isn’t to be perfect; our purpose is to stay sober and help others. It really is that simple. It’s not the huge Machiavellian conspiracy that’s being posited here.

The way we are being portrayed here is prejudicial and false. We are being portrayed as a bunch of people who must all think the same way, a bunch of Judeo-Christian fundamentalists who do nothing but sit in folding chairs, yet are somehow plotting to take over this or that aspect of the world. These characterizations are untrue.

I understand that the main target here is the treatment industry, but it is disingenuous to say that it is all right to mischaracterize AA in all of these ways just because the treatment industry is the target–and so therefore criticism of AA is allowed, but defense and explanation are somehow off-topic. One can’t have it both ways. If one is going to bash AA as one goes about bashing others, then of course it’s legitimate to point out how AA has been mischaracterized.

This intolerance toward–and generalized mischaracterization of–a diverse group of people is, to my mind, akin to one of the chief “hallmarks of religious fundamentalism.”

In response to above two posts, I have only claimed that *some* AA members engage in the type of forceful and proselytizing manner described, and that is an empirical fact. Next, I have stated again and again that many within AA, including atheists, find a way to a higher power, that I could not, but that I am glad for those whom it works.

In terms of a higher power, I hardly think I’m the most powerful person in the world; quite the opposite is true. But let’s say I took a natural power, one that could be proven to exist: for example, let’s make that higher power nature. Can nature really remove my “character defects”? Can any empirically-proven power remove my “character defects”? The answer is emphatically “no.” These are what might be called blind forces, the results of evolution, biology, physics, etc. By their very nature, they don’t “care” about my “character defects” or anything else. Still, if someone finds that such alternatives work for them, that’s fine with me.

I did not claim that all AA members are religious fundamentalists; I stated that *some* AA members act worse than religious fundamentalists. There is no arguing with them. This case proves my point. I did not raise the issues that AA members continually raise; AA members did.

To say that AA only works if one works the program *can* become circular logic. Even if a person finds the program helpful but continually relapses, they will be told they’re not “working hard enough.” That can be stated into the infinite future but will more likely result in the person leaving AA for good and returning to either a life of abstinence without AA or, more likely, drinking, since no alternative programs exist in most areas — not because AA and only AA works.

AA itself may not claim to be the only way, but many of its members certainly do so. As mentioned, I have been threatened that I would die if I did not attend AA. No, I would have died had I not stopped drinking.

“AA member” is just a shortcut. I realize it’s not a club. However, I don’t want to repeatedly use the phrase “those who attend AA meetings on a regular basis.”

Finally the very history of AA reveals that it was developed through Judeo-Christian, and more specifically Christian, theology, and with the assistance of Christian theologists. Christian redemption themes run throughout AA’s literature. This cannot be denied; it is empirically true. A person may not realize this, or choose to ignore it, but the fact remains. If a person would like links to this issue, I will be happy to provide them. But even if all AA members were Christians, and AA only allowed Christians to attend, I wouldn’t care. It’s not the point.

It’s *my* argument that’s being distorted and mischaracterized. That’s because everything in this post is unquestionably true, but it will again be misrepresented, attacked, etc., simply because those who attend AA meetings choose their own definitions and, by doing so, not only make AA into anything they want it to be but do the same to any article or discussion that mentions AA in all but ways in which a halo exists over the words “Alcoholics Anonymous.”

Now you’re trying to have it both ways again. You say “those who attend AA meetings choose their own definitions and, by doing so . . . make AA into anything they want it to be.” That is true, to an extent–for instance, one gets to define “higher power” as one chooses. But even if you meant that statement as absolutely as it is written, it destroys your entire argument that AA is a religion, a cult, a monolith, or even any kind of an organization.

In no religion or cult is one allowed to “choose their own definitions.” Your evidence for attacking AA as being inflexible is to cite how flexible it is! This is extremely sloppy thinking. If AA’s defenders, as you claim, are coming at you from every possible rhetorical direction, then that is all the evidence you need that you are not dealing with a dogmatic monolith.

AA is not an organization, and does not have leaders of any kind, but is instead a very loose fellowship, an extremely big tent that allows a tremendous multiplicity of points of view. Your own reported experience with people from AA gives the lie to your central tenet that the fellowship is a dogmatic monolith.

Another anomaly is that you define an AA member as a person “who attends AA meetings regularly.” This is an extremely shortsighted view of what AA is all about, and doesn’t differ much from the total knowledge of AA that a member of the general public might have. AA is a gigantic toolbox, and meeting attendance, while important, is only one of the many tools in that box.

As I said before, simply attending meetings does not constitute working the AA program. Yet the few statistics that exist on the efficacy of AA are based on meeting attendance, not on working the program.

In 24 years, I have never seen anybody who is working the program go out and drink. Somebody with a service position in the group, who is being sponsored and who is sponsoring somebody else, who communes with a higher power, who socializes with fellow AAs outside the meeting room, and who uses the many other tools is not, in my experience, going to go out and drink. A person who sees AA as you see it–simply passively attending meetings–doesn’t have much of a chance. Again, it’s like anything else in life–if you want The Promises to come true, you have to work for them. And I’m not talking about white-knuckle “sobriety”–I’m talking about The Promises, which are clearly outlined in our literature and which, incidentally, have nothing at all to do with Christianity.

But as far as meetings go, there are many different ways to attend them, and in your reductive approach you fail to make any distinction even there. A person can sit in the meeting passively, even hostilely, and never speak. (But hey, even some of them eventually get sober!) Or a new person who shares can mistakenly believe that the only purpose of sharing is to sit there and bitch about his life. Or a more experienced member might recognize that the purpose of sharing is to ADD something to the meeting, specifically on that day’s topic. Again, AA is not the monolith you presume it to be, and even meeting attendance, which is only ONE of the tools, can mean vastly different things to different people.

Having said all this, I’ll grant you that it is possible for an actively engaged member to go out and drink, although I have never seen it. (Typically what happens is that a person stops working the program and THEN goes out and drinks.) The AA program is paradoxical in many ways–it teaches control, for instance, through the route of admitting powerlessness. By admitting powerlessness, I become powerful. But that power extends only to the first drink. For the sober person, the first drink is a choice, and all bets are off for the subsequent ones. So it is theoretically possible for a person who is fully engaged in working the AA program to DECIDE to take that first drink. I’ve never seen it happen, but that doesn’t mean it doesn’t happen or couldn’t happen. All we have is a 24-hour respite, and any of us could decide to drink–tomorrow.

This has been an extensive discussion, and this is the first time the 24-hour plan has been mentioned. Many thousands of words can be written about it. I’m not going to do that here, but will mention it only to point out that there are many features of the AA program which you have ignored in your critique. Your total definition of AA is that it is about going to some meetings and having to define everything the same way everybody else does, and you are wrong on both points, as your own evidence shows. If you really want to talk about AA you have to address all of it. A sideways bash like yours simply is not intellectually rigorous, even if your main interest is in bashing the treatment industry, which in fact is not run by AA–another error in your reporting.

Finally, what you say about the Christian roots of AA is a red herring. As I’ve already demonstrated, AA does not operate like any religion in the world. True, there were Christians who were part of AA in the past, and Christians who are part of it today. But the message of Christ is nowhere to be found in AA or its literature, just as the message of Christ, in my opinion, is nowhere to be found in the Christian churches. In any case, your argument is like saying the United States is a monarchical nation because Britain founded the colonies. It is a specious argument.

Instead of working on Christian principles, AA works on a system of enlightened SELF-interest. Why do I help others in the program? Because doing so helps ME. That is the only way you’ll ever get an alcoholic to do anything–show him how it benefits HIM.

That is part of the brilliance of AA, and part of the secret of why it works (as distinct from how it works). AA takes all of the screwed-up, selfish thinking of the alcoholic and bends it around in ways that are designed to keep him sober. I could write a book about how AA does not, and perhaps I should.

Thank you for the conversation.

I had composed a lengthy response to your post, complete with links to reliable sources. However, for some reason, the post never appeared. Therefore, I am going to post a much briefer response, as I’m short on time.

1) In terms of your claim that I labeled AA a “cult,” you took my statement out of context. In context, I stated the following: “It’s not the existence of AA, or that many agree with what its claims, or bend what it claims until it matches what they prefer it to mean, that irks me. It’s the idea that no one else can possibly be right, an absolute certainty, which are the hallmarks, I’m afraid, of cult members.” Therefore, I did not call AA a cult. I stated that some percentage of AA adherents act in a cult-like fashion.

2) The argument that AA is not an organization is so facile that it hardly deserves a response. However, I will only note that the AA site address ends in .org, as in “organization,” that AA refers to itself as an organization in its literature, though preferring the term “fellowship,” and that AA is a non-profit organization. It also has a structure with board members. Therefore, it is an organization, though why that term should disturb AA adherents is beyond me.

3) The claim that those who fail to continue participating or remain sober in AA because they are not “working the program” amounts to circular logic. Obviously, by that anti-reasoning, any statistics of any nature evaluating AA’s effectiveness would show it to be 100 percent effective in 100 percent of all cases, an absurd claim by any standard.

4) You seem to presume I have never been to meetings or have only attended one or two. Actually, I attended many meetings and in more than one state. I simply decided to “purchase”
a different toolbox.

5) Regarding Christianity and AA, the latter is steeped in the former. The red herring is the terminology “God of one’s choosing.” I think we know the specific God to which the founders referred. They were willing to “accept” those of any religious background and even agnostics (the Big Book tellingly does not address atheists; it obviously considers them to be “lost souls”). Interesting, however, and contradictory, was a surprising discovery upon which I stumbled during my research for my original reply to you. I was going to provide a link to an example of the following, but you can easily find similar evidence on your own. Anyway, some Christian churches and groups reject AA, claiming that it’s not “really” Christian but a sort of “new age” approach, one that removes “personal responsibility” and “rejects” certain passages of the Bible. That’s as outlandish a claim as to state that AA works 100 percent of the time or 0 percent of the time. So, I will grant you that AA, to my surprise, is assailed from several angles, including, in some cases, the Christian angle.

6) As to the supportive nature of the meetings, the shared reaching out, etc., I agree. Any alternative to AA should certainly include that vital element.

That concludes my remarks regarding AA, as I am now about to note in my next comment.

Thank you for your thoughts.

~ Paul A. Toth

A Note to Those Engaged in the AA Debate

Thank you for your comments; we must agree to disagree. I am no longer going to address comments that deal with the issue of AA, including what it means, whether or not it works, the supposed inaccuracy of my viewpoint, the false assumption that I oppose AA, the false assumption that I have not attended enough meetings to be fully aware of AA’s workings, the false assertion that I cannot read and understand what the simple words of Step 6 mean (words with which I have expressed no concern except in regards to the treatment community), etc. You are welcome to agree with each other amongst yourselves.

I will continue responding to comments specifically addressing the subject of the article, that being the treatment community and not AA.

Thank you for the discussion. I hope it continues, though I also hope it returns to the point of the article, which the expected Word War regarding AA seems to have destroyed.

Best of luck to all of those in recovery, whether you take the AA approach, or a different path to rational thinking.

Sincerely,

Paul A. Toth

I’d like to start a new line of discussion. This suggested discussion is not intended to create a debate about the need for support groups, whether AA or its existing alternatives. Obviously, psychological issues, or however one interprets the emotional/thinking aspects of alcoholism, need to be addressed.

Question:If alcohol really is a disease, shouldn’t it primarily be treated by physicians?

I agree, the you tube videos are confusing of the all in the head linked to jenny mccarthy dystonia caused by vaccine cheerleader. What’s NOT confusing; however is the factual discoveries of her pyschogenic disorder. In short, she really thinks she has dystonia, thus presents as such. Similar cases are seen in the case of psychogenic autism (factitious disorders) where the persons either deliberately feign being autistic or they really believe they are autistic. Normally, you find this in people who have taken large amounts of LSD type drugs, combined with a severly abusive past, thus resulting in a very mixed presentation of whatever it is they feel will bring them the most attention and nurturing. Autism is popular today, so many mentally ill persons are adopting this persona. Mainly, because few, if any professionals or media will challenge such a diagnosis after even a less than competant professional duped by the complexity of the presentation—validates it. Ooops, than it becomes a save face issue, where neither the media or the professionals (not to forget publishers who publish stories that later turn out not to be autistic people) involved in the faulty diagnosis want to be embarrassed. This is unfortunate, as this does a great disservice to the autism community in general. Recall the Amanda Baggs controversy and the case of Ms. Donna Williams. You Tube has a recent video out discussing some of this I’ve mentioned. It is on you tube under the name, “autism spectrum seems out of control” and another video named, “autism epidemic out of control.” The video has most definately hit on something few outside psychoanalytical or psychiatric circles, have even noticed.