The founders purposely left the door open for science to come into the realm of recovery, and unlike modern AA, they did not discount its potential importance when it came to helping people.
I am an alcoholic, or, as conventional wisdom goes, an alcoholic in recovery. I’ve had my share of rehabs, detoxes, and IOPs. I’ve dealt with numerous counselors, doctors, psychiatrists, and even a hypnotist. I have mastered “white-knuckling.” And I’d “given myself fully to the simple program” that is AA. Nothing worked. This is not to say I did not have my dry spells, as well as full-on productive years of zero consumption of anything that contained ethanol. Still, I relapsed, and went down a black spiraling abyss pretty confidently when my consumption quickly became prodigious in both amount and frequency of use.
Sheer yet fully predictable insanity ensued. Binges went on for weeks and ER visits became routine. Doctors gave me a bleak prognosis, as coming out of the drinking spells had become nearly impossible. Maintenance drinkers had nothing on me — I drank to breathe, to sleep, to go to the bathroom. Beer and wine became juice, annoyingly un-intoxicating. Blended whisky — aka brown vodka — was the only thing that worked, before it didn’t. A rehab intake clocked me at .43 blood alcohol content, with the fatal spectrum usually starting around .35. I am not a large guy by any means; turns out it was the tolerance I’d developed that saved me from kicking the bucket from alcohol poisoning. I stayed drunk for two days just on what was in my bloodstream, and then the withdrawal hit like a train. Librium, Zofran, Librium. An in-house doctor woke me up; my pulse was barely there. But, as always, thankfully, in a week I started feeling better.
A Revolutionary Program… for 1939
The role of AA in my recovery has been significant. The fellowship of men and women — a genius brainchild of Dr. Bob and Bill Wilson, and wholeheartedly endorsed by Dr. Carl Jung himself, has helped countless families. It is incredible in its selflessness and honesty and yet, today’s AA is rigid, too antiquated, and legacy-driven. It’s normal, though, for an organization of this stature and with this much history. After all, back in 1939 this was an absolutely revolutionary, even visionary, break-through. But we’re not in 1939 or even 2009, and so AA must adapt or it will lose its edge.
Both Dr. Bob and Bill Wilson were complex, highly educated, empathetic, and caring individuals. Their realization of a prominent role of Higher Power in recovery did not come easy. Skeptics, cynics as they were, they had to overcome an internal struggle before making peace with the fact that human nature was helpless in the face of the monstrous foe of addiction. The resulting text, which we all now know as the Big Book, was the product of a multi-year intellectual effort, which was by no means easy or straightforward. For example, one little-known fact about the book is that initially it used the 2nd person throughout its chapters, as in “you recover, you need to, you have a problem.” The authors decided to change it to the 1st person (we), which brought a completely new tone to the script. From preachy and authoritative it became welcoming and tolerant.
In addition, when it comes to finding ways to recover from alcoholism (specifically becoming a “normal drinker” as opposed to an alcoholic), the Book mentions that “science may one day accomplish this, but it hasn’t done so yet.” In fact, multiple recovery groups and schools of thought have stepped in to fulfill this prediction. For instance, the Sinclair Method introduced its harm reduction model, based on the pre-emptive use of Naltrexone to reduce cravings and use. Like with everything else, if it works for you, great. It did not for me or any other alcoholic I know.
AA’s Founders Expected AA to Change
The founders purposely left the door open for science to come into the realm of recovery, and unlike modern AA, they did not discount its potential importance when it came to helping people. Today’s AA, on the other hand, has forgotten that approach, adopting more of a “my way or the highway” when it comes to alternative recovery techniques.
My respect and love for AA is beyond mere deference. I firmly believe that its overall purpose is remarkable. However, I also know that it could be more effective in reaching more people if it actively adopted — or at least discussed — modern-day scientific findings when it comes to addiction. Yes, rigorous honesty and humility are key, however, an inquisitive and questioning mind is not something that should be shunned; on the contrary, it should be celebrated. Ask Bill Wilson.
The Book should be akin to the concept of a “living, breathing” Constitution, which celebrates evidence-based evolvement of the original understanding of the Supreme Law of the Land (for example, ever-present discussions of the Fourth Amendment as applied to modern-age surveillance technology. Back when it was written, there was no phone or Internet surveillance, yet the maxim against unreasonable search and seizure is alive and well). Evolution of approaches, when it comes to addiction treatment, is a natural occurrence and fighting it is like trying to cross-breed humans and monkeys hoping we can get better, more advanced Homo sapiens, or even a new humanoid altogether.
Let’s also take a look at the concept of singularity, as defined by famous futurist and (coincidence?) Google’s Director of Engineering, Ray Kurzweil. Essentially, he summarized it as an ever-developing concept of a progressively consequential role of technology in everyday life. One of the most striking illustrations of that concept is Kurzweil’s conclusion that today, an average child in Africa (or Russia, U.S., Cuba, China, etc.) with an off-the-shelf smartphone has more information at her fingertips than the president of the United States had 30 years ago. As any brilliant idea, singularity was successfully explained and encapsulated in simple terms by the above example.
Science and Spirituality
The same type of evolution awaits AA in particular, and the fight against addiction in general. Get with the program or get run over, as progress does not stop, and that is exactly what Bill Wilson understood so well in his pragmatic ingenuity.
From the reptilian middle brain and limbic system responsible for survival hijacking the thinking territory of the prefrontal cortex (in the AA lingo, home of the white-knuckling demon), to the brain’s neuroplasticity and ability to heal itself and learn new reward pathways after alcohol (or meth, heroin, porn, etc.) has done its scorched-earth number on its dopamine receptors, today’s science has explained it all. That is not to say that it has effectively pre-empted the field and left no room for miraculous recovery (doctors sometimes call it spontaneous remission) or any other spiritual component. To the contrary, following Dr. Carl Jung and his glorious pronouncement Spiritus Contra Spiritum, with which he famously concluded his 1961 letter to Bill Wilson discussing the viability of AA, science leaves ample room for spirituality when it comes to addiction. Now it’s time for AA to return the favor and welcome science in its rooms.
AA (or any other single-tier approach) cannot win this war on its own. And I am not even talking about the alleged (yet well-researched) 5-7 percent long-term success rate of AA (see Lance Dodes, MD, The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry).
What I am referring to instead is inclusiveness and intentional wariness of rigidity. Like Tolkien’s Balrog, addiction is a shape-shifter, a cunning, conniving, vindictive foe with an overpowering ability to maim and kill. Gandalf the Gray — arguably the strongest protagonist of Tolkien’s Middle Earth, simply could not dispatch the demon of all demons through his conventional, albeit awe-inspiring powers, and had to adjust and in a way shape-shift himself into Gandalf the White.
So, who’s to say that what’s good for the U.S. Constitution, Kurzweil, and Gandalf is not good for Alcoholics Anonymous? More importantly, will AA even survive if it doesn’t embrace its own evolution?