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Story Pick: The Secrets of Alcoholics Anonymous

Brendan I. Koerner, a contributing editor at Wired magazine, opens his intriguing piece on Alcoholics Anonymous with a darkly comic scene.

The church will be closed tomorrow, and the drunks are freaking out. An elderly lady in a prim white blouse has just delivered the bad news, with deep apologies: A major blizzard is scheduled to wallop Manhattan tonight, and up to a foot of snow will cover the ground by dawn. The church, located on the Upper West Side, can’t ask its staff to risk a dangerous commute. Unfortunately, that means it must cancel the Alcoholics Anonymous meeting held daily in the basement.

Many people think they know what Alcoholics Anonymous is about. The 75-year-old organization has been the subject of articles, dramatized, and lampooned in films and other art for years. Its 12-step program to treat addiction is ingrained in our collective psyche. In his new Wired piece, though, Koerner poses some fairly basic questions about the organization that no one seems to have the answer to. Which part of AA's program -- such as an addict's apology to someone he or she has wronged, or surrendering to a higher power -- works the best? "Stunningly, even the most highly regarded AA experts have no idea," Koerner writes. He adds: "The problem is so vexing, in fact, that addiction professionals have largely accepted that AA itself will always be an enigma. But research in other fields—primarily behavior change and neurology—offers some insight into what exactly is happening in those church basements."

Koerner's piece offers a thorough look at the research behind addiction, addiction therapy, and AA's history. The most compelling part, however, is the article's introduction, when Koerner immerses us inside that actual AA meeting at a New York church. After the attendees were told that the next meeting was canceled due to snow, Koerner shows how the group reacted:

A worried murmur ripples through the room. “Wha… what are we supposed to do?” asks a woman in her mid-twenties with smudged black eyeliner. She’s in rough shape, having emerged from a multiday alcohol-and-cocaine bender that morning. “The snow, it’s going to close everything,” she says, her cigarette-addled voice tinged with panic. “Everything!” She’s on the verge of tears.

By Ian Shapira  | June 24, 2010; 6:28 PM ET
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I think this is a perfect illustration of how AA is used as a substitute addiction. Without the 'magic' of AA this woman believes she'll be struck drunk.

AA does not improve on the rate of natural remission (people quitting on their own). The program has become a knee jerk reaction for people who don't want to deal with matters of addiction: Ship 'em all over to rehab and AA.

Koerner's article starts with the faulty premise that AA does work. 95% of all newcomers drop out within the first year, the few that stick around are the ones who believe they're getting something out of it and heavily promote the program.

The Harvard Mental Health Letter reported that 80% of all alcoholics quit without any type of treatment or program. The 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions showed "About 75 percent of persons who recover from alcohol dependence do so without seeking any kind of help, including specialty alcohol (rehab) programs and AA. Only 13 percent of people with alcohol dependence ever receive specialty alcohol treatment."

So why are we sending people to programs that teach them they have a lifelong disease that they are powerless over, one that cannot be cured, only arrested through Divine Intervention and meetings for life?

Today we have evidence-based practices, programs that empower a person to make positive changes in their lives have better success rates.

Posted by: raysny | June 25, 2010 12:02 PM | Report abuse

What's wrong with this picture?

From the Wired article, "Daily meetings, the man says, are all that prevent him from winding up dead in the gutter, shoes gone because he sold them for booze or crack. And he hasn’t had a drink in more than a decade."

He's been going to AA for a decade, yet in ten years he's not developed any personal strengths or abilities of his own, but will simply fall apart if he misses a meeting.

This may be just a fictional story (I don't know), but I've seen it happen for real in AA. A man with thirteen years fell apart without a meeting and relapsed horrendously. And there have been others.

(And don't forget the people who come to meetings daily and never miss, yet can't stay sober. Something isn't working.)

Likewise the panicked woman. One evening the church was locked. AA members were frantic and confused. They didn't know what to do, and were desperate and helpless.

I said, "Let's sit down in the parking lot. I'll recite the steps," which I did from memory. I went ahead and led a spontaneous meeting without needing literature or coffee or chairs or ashtrays.

What's wrong with this picture? I found myself asking why AA members are so helpless, falling apart if they miss a meeting, becoming desperate and panicked if their routine is disrupted.

(I know. The answer is that they are Diseased and Powerless. And anyone who questions this is "killing alcoholics".)

It was becoming clear to me that AA does nothing to cultivate strength and self-reliance in members. Rather, AA keeps preaching the Dogma of Powerless Disease and punishing anyone who develops self-reliance. Members are rewarded for showing hysteria and panic in unexpected situations. I've seen this, I was there, I was an AA member for 12+ years.

This Washington Post blog begins, "Brendan I. Koerner, a contributing editor at Wired magazine, opens his intriguing piece on Alcoholics Anonymous with a darkly comic scene."

What's comic about this? What's comic about people who are encouraged to believe they're helpless and incompetent when their routine is interrupted? I don't think it's funny at all.

I've left AA. I've left, because I think this AA nonsense isn't comic or funny at all.

I agree with the things my CyberFriend raysny has written here.

Posted by: Laurance1941 | June 25, 2010 7:15 PM | Report abuse

As one member(15 years sober)who attended AA a few times unsuccessfully before it worked for me ...
raysny, concerning the Harvard study - "alcoholics" who quit on their own aren't really alcoholics - they are alcohol abusers who stopped. Alcoholics suffer from a compulsion to drink, and a compulsion, by definition, is something one finds themselves unable to stop without some form of outside help.
Laurence1941, the reason why AA 1st year success rate has dropped over the past decades is due to "early-stage" alcoholics being forced to meetings by the court system, particularly for DUI. Most of these people are using AA simply as a means of beating the legal system, and have no intention of giving up alcohol. They drop out quickly, thus increasing the "failure rate" of AA.
Last, I've heard of AA referred to as a cult, brainwashing, religion, etc.. AA has open meetings where anyone can attend. I know some members who are atheists. We live pretty normal lives. And no, we don't relapse just because "the church is closed". BTW, admitting one's limitations and working around these limitations builds strength; refusing to admit limitations results in delusion and weakness.
Having said all that, if AA is no good for you for whatever reason, there are other options, such as Rational Recovery. Search engines will lead you to these options.

Posted by: dminnich312 | June 27, 2010 5:29 PM | Report abuse

Refarring to a program that works for so many people as "magic" seems a pretty negative view - and probably from someone who has no experieince with AA.
Granted, the bumper stickers and catch phrases aren't for everyone, the point is that most of the people in the program really understand addiction. How many people continue to point a finger at the addict, as if drinking into oblivion is a choice anyone really would make? Answer: Many, and that includes family members.
AA is simply a program of support and encouragement for people who want to stop drinking. So yeah, I suppose there is some magic in that.


Posted by: Lisaehern | June 28, 2010 5:24 PM | Report abuse

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