Despite a total lack of any scientific evidence whatsoever, adherents cling steadfastly to the belief that the 12-steps are required for genuine, bona-fide “recovery.”
Not so long ago, I was a regular attendant at meetings of Alcoholics Anonymous, America’s foremost response to the twin problems of alcoholism and addiction. I was a genuine “winner,” as we were sometimes called, meaning an engaged, entrenched, active long-timer, a 12-step practitioner with uninterrupted clean-time extending over multiple decades. It was largely thanks to AA that I learned how to be a drug-free and sober human being.
I successfully lived the AA lifestyle for a quarter of a century. I am the literal opposite of a revolving-door type, or your standard AA-hater. I am stating these autobiographical facts because my essentially positive experience has direct bearing upon the reliability and veracity of my subsequent critical observations. It behooves me to simply point out, with tongue in cheek, that my doing so is not the result of any sour grapes.
My problem with Alcoholics Anonymous and the 12-step sub-culture in general has to do with their nature as pseudo-science. Pseudo-science refers to any given explanation which is either presented as, or accepted as, scientifically plausible, despite a lack of scientific veracity. A pseudo-scientific account is one which is considered to be equally truthful, and genuinely explanatory, as one which has been scientifically validated, even though it is not the result of an epistemologically sound process such as the scientific method, and therefore does not merit the same degree of confidence.
Eventually I had to leave the fellowship, and this was due primarily to my experience of awakening to the fundamental truths of atheism. AA is a very religious organization in every sense, although members are generally loath to acknowledge this fact. This religiosity includes the fundamental intolerance, and the proselytizing, so endemic to the Abrahamic religions of Christianity and Islam. “Carrying the message” is written into the 12-step program and is, in fact, touted as an important way of staying clean. One carries the message to another, who carries the message to yet another, who carries the message, on and on like that. It was only upon leaving that I came to recognize many of AA’s glaring defects. In retrospect, I was able to acknowledge how 12-step recovery essentially functions much like a sobriety ponzi-scheme, from which only a rare few garner the genuinely elusive, long-term benefits, pseudo-scientifically claimed to be available to all who “thoroughly follow our path.”
There is an inherent institutionalized prejudice against alternative approaches. One is discouraged from speaking of different methodologies. AA dogma was, and remains to this day, glaringly anti-alternative, and particularly anti-science. A single line or two, on “making a normal drinker out of an alcoholic,” is all that appears in the text of Alcoholics Anonymous, summarily dismissing empiricism and scientific R & D with:
Science may one day accomplish this, but it hasn’t done so yet.
Of course, the assumption that the goal of science would be to make us into “ordinary drinkers” is itself rather dubious and small-minded to begin with. There is an endless array of possibilities which science can bring to bear on solving problems of this kind. But the 12-step mind set dominates the field of recovery, both in terms of short-term detox and treatment facilities, and also regarding long-term lifestyle changes. As with Christianity more generally, it’s “my way or the highway.”
The more time one spends immersed in the subculture, the more difficult it becomes to think outside the box, to think in any alternative way about the problem, or possible solutions. This hinders the process of developing alternative approaches and perspectives, and thereby of improving the current unarguably poor success rate. Once you’ve bought the package, you become invested in the belief that it’s a “spiritual” problem, and only a “spiritual” solution, requiring a “higher power” of some kind, will work. In a classic falsifiability move, anyone who claims otherwise is summarily dismissed as being “in denial.” Does this sort of unfalsifiable, self-justifying language sound familiar? Certainly, as it constitutes a major component in the religious thinking so central to the world-dominating religions of Christianity and Islam.
Suboxone is one example of a good, though admittedly not perfect, scientific alternative. After 23 years of total abstinence, I suffered a major back injury while playing basketball. I was in severe, chronic pain, and forced to have surgery. This whole scenario necessitated a regular regimen of intensive, doctor-prescribed opioid use, legitimately, for physical pain. But, being the addict I am, it was not long before I was well beyond what the doctor ordered. Unable to stop by any other means, including intensive step work and immersion in the fellowship, Suboxone freed me from the obsession, the overwhelming cravings which I suspect only an alcoholic or addict can truly understand. At the same time, it allowed me to bypass the extremely difficult and unpleasant process of opioid withdrawal. Suboxone literally saved my life.
Several years after leaving AA, I am currently happier and more stable than ever before in my life. But, despite this first person account, most 12-step members can be counted upon to object, to offer a handful of very predictable critical responses. Because Suboxone actually administers a small dose of opiate along with the blocker, many would claim that I’m not actually “clean and sober.” They would also claim that I am “in denial,” and not in genuine recovery, but merely a “dry drunk,” because I am not engaged actively in step work, have no sponsor or sponsees, do not attend meetings or have a “higher power” in my life. Despite a total lack of any scientific evidence whatsoever, they cling steadfastly to the belief that the 12-steps are required for genuine, bona-fide “recovery.” This is the very epitome of what is meant by pseudo-science.
How much of this way of thinking stems from the early Christian roots of Alcoholics Anonymous? The most popular method for dealing with alcoholism before AA came into existence was a Christian fellowship known as the Oxford Group. Bill Wilson, a drunkard and a salesman from small town New England, fell back upon the Oxford Group’s fundamental principles when he fathered AA into existence in the 1930’s.
During one of his many detox/treatments, Bill was given the “Belladonna Cure.” Completely ignoring the fact that he was under the influence of a potent, toxic, mind-altering drug, Wilson interpreted the subsequent hallucinogenic experiences in a familiar Biblical manner. His prophetic interpretation of the proverbial white light experience, with its mystical aura and spiritual connotations, served to make his message all the more vivid and valid, imbuing it with divine, super-human authenticity. Alcoholics by the millions, including my young and impressionable self, gobbled that shit up. Despite being raised in a non-religious household, I found myself anticipating my very own prophetic, white light, burning-bush type experience shortly after leaving the adolescent treatment ward at Hazelden and beginning my 90-in-90.
Wilson intentionally fashioned the fellowship upon Christianity. His steps numbered 12 in an homage to Christs apostles, while they simultaneously mirrored the check-list format so familiar from the ten commandments. Portions of Alcoholics Anonymous, the highly venerated “Big Book” that is fundamentally the organization’s scripture, are read aloud at meetings. The most frequent reading is the opening portion of Chapter 5, with the telling title How it Works. This is where you‘ll find Bill Wilson’s infamous steps, recognized, copied, and employed around the world, and for far more than alcoholism alone. In a flagrant pseudo-scientific manner, these are generally accepted to be an essential element of the “program of recovery,” both within AA, as well as within the majority of America’s 15,000 rehab facilities.
As the opening paragraphs introduce these steps, we find this unambiguous gem:
Without help it is too much for us. But there is One who has all power — that One is God. May you find Him now!
Wilson’s steps follow, consisting of no less than 7 specific references to an interventionist, loving, paternalistic deity. Afterwards, this ubiquitous reading is finished off with the “ABC’s of recovery”:
(a) That we were alcoholic and could not manage our own lives.
(b) That probably no human power [i.e., science, medicine, etc.] could have relieved our alcoholism.
(c) That God could and would if He were sought.
Bill Wilson and the text Alcoholics Anonymous are clear and demonstrative examples of apotheosis, the process by which a human being, and their words or works, are deified or divinized. As a participating member, I regularly heard claims like “god spoke through Bill W.”, that Bill was “divinely inspired,” and that the book itself was “sacred.” Sections of the book are inscrolled. They hang from the walls of every meeting in a classic parchment-style format, intentionally reminiscent of Egyptian papyri and Biblical times, all in an effort to gain a measure of authenticity-through-antiquity, doing Cecille B. DeMille proud.
Just as with biblical or quranic scripture, passages are oft-quoted, repeated, chanted, highlighted, memorized, prayed upon and meditated upon. Questions regarding addiction or recovery are answered with quoted lines from the work, oft considered to be wholly authoritative: “See? It says so right here.” There have been efforts to change the primary text, but they have met with steadfast resistance, in spite of the fact that the text is grossly outdated and problematically ineffective.
And, in the end, it is this ineffectiveness which is really the bottom line. Members are disinclined to acknowledge two fundamental truths about Alcoholics Anonymous:
One: it’s religious as hell, and
Two: it’s secretly, disturbingly ineffective.
If the latter were not the case, one might be more inclined to consider forgiving the former. I know the nightmare that is addiction and alcoholism intimately and first-hand. I would not wish this particular affliction upon my worst enemy, as the saying goes. In my mind, anything which works to help someone out of its agonizing throes is worthy of consideration. I would begrudge no sufferer any feasible solution to this dire and woeful condition. I am not so much anti-AA as I am anti-pseudo-science. I am opposed to “solutions” which do not actually solve the problem at hand.
While notoriously difficult to measure, there is nonetheless general agreement amongst professionals that the success rate of AA hovers somewhere around 10%, with an estimate of 20% being considered generous by most. I am simply pro-improved success rate, which necessitates me being pro-alternative. AA represents a faulty, problematic answer to what is a very serious problem. Unfortunately, by its very nature, it serves to hinder alternative efforts at improving the chances of those who are afflicted with this particularly vex-some condition.
What is my purpose in writing this essay? What is the point? Just more “AA bashing”? Several responses come to mind. First of all, members of Alcoholics Anonymous, especially those who have become counselors, therapists, volunteers, or are otherwise involved in the multibillion dollar per year treatment industry, should stop being “in denial” themselves, and begin opening themselves up to alternatives. They should stop denying that AA is fundamentally religious; they should stop denying that its success rate is very poor; and they should seek to be especially critical of the manner in which the big book and the propaganda of the old-timers nurture a “blame the victim” mindset.
It is either simply flat-out false, or at best pseudo-science, to tell newcomers “god could and would if he were sought.” You are simply surrendering them to the placebo effect when you do so. And when they fail to attain their goals, many will fan the flames of misery by blaming themselves for the failure. People do not necessarily fail at 12-step because they didn’t try hard enough, or didn’t have a low enough bottom, as are commonly held to be the case. The problem is much more that 12-step is pseudo-science, and works for only a very small percentage of those who suffer from our condition.
Equally important, all of us must acknowledge that 12-step is pseudo-science. As such it is both claimed and understood to be more effective than it truly is. So long as we continue to believe confidently that it is a “spiritual problem,” which can only be solved with the help of a “spiritual solution,” with help from a “higher power,” we will continue to have results which roughly parallel those of the placebo effect only. More practical, pragmatic, evidence-based, and genuinely scientific solutions will continue to be looked upon as infringement, and those who propose them continue to encounter condescension, derision, intolerance, and rejection.
If you have 10 or 20 years, and you work helping others in the profession, in treatment facilities, or sponsoring a lot of others, then you are probably more of a part of the problem than you realize. Enthusiastically seek out and encourage alternative approaches which are, rather than pseudo-scientific in nature, genuinely evidence-based. Stop promoting the steps as if they cured alcoholism or addiction. They don’t. “Rarely have we seen a person fail who has thoroughly followed our path” is a false claim of a pseudo-scientific nature, a lie that has sent countless alcoholics and addicts to their grave. It is time for a change.