The Science of 12-Step Programs 330
Hugh Pickens DOT Com writes "Since the inception of Alcoholics Anonymous — the progenitor of 12-step programs — science has sometimes been at odds with the notion that laypeople can cure themselves because the numerous spiritual references that go with the 12-step program puts A.A. on "the fringe" in the minds of many scientists. But there is an interesting read at National Geographic where Jarret Liotta writes that new research shows that the success of the 12-step approach may ultimately be explained through medical science and psychology. According to Marvin Seppala, chief medical officer at Hazelden and sober 37 years, attending 12-step meetings does more than give an addict warm, fuzzy feelings. The unconscious neurological pull of addiction undermines healthy survival drives, causing individuals to make disastrous choices, he says. "People will regularly risk their lives—risk everything—to continue use of a substance." Addicts don't want to engage in these behaviors, but they can't control themselves. "The only way to truly treat it is with something more powerful," like the 12 steps, that can change patterns in the brain. Philip Flores, author of Addiction as an Attachment Disorder, says the human need for social interaction is a physiological one, linked to the well-being of the nervous system. When someone becomes addicted, Flores says, mechanisms for healthy attachment are "hijacked," resulting in dependence on addictive substances or behaviors. Some believe that addicts, even before their disease kicks in, struggle with knowing how to form emotional bonds that connect them to other people. Co-occurring disorders, such as depression and anxiety, make it even harder to build those essential emotional attachments. "We, as social mammals, cannot regulate our central nervous systems by ourselves," Flores says. "We need other people to do that.""
Gotta have a plan (Score:5, Interesting)
I would suspect that programs such as these do work, because they provide a means of seeking help, support and resisting temptation, instead of having no direction to go but down.
More nonsense (Score:1, Interesting)
"Addicts don't want to engage in these behaviors, but they can't control themselves"
Nonsense. Read 'Addiction is a choice' and 'The myth of addiction'.
There is no such thing as 'addiction'. Every so-called 'addict' CHOOSES to engage in whatever behaviour they are doing, which is called an 'addiction'. Alcohol doesn't force you to pick up a bottle, doesn't move your arms for you, etc.
People take drugs because they are UNHAPPY, and if they stop taking those drugs, their real feelings come to the surface, which they have been trying to avoid all their lives, and they will do anything to continue avoiding them. That is all there is to it.
Re:quit drinking (Score:5, Interesting)
Well their terminology may be a bit off but the idea is actually correct: You can't, at this point, be "cured" of alcoholism. You can stop drinking and that is what you need to do, but the addictive nature is still there. If you start again, you'll overdo it and spiral down the addict path. If your brain/body is such that it will get addicted to alcohol, then it will always be that way, and no amount of time will change that.
That's really what they are saying and it is correct. You don't cure an addiction, as in become such that you won't get addicted to the substance, you just stop taking the substance.
As an example take a look at nicotine. There actually are people who do not become addicted to it, my mother is one of them, they are just very rare. Most people, if you use it more than a little bit you WILL get addicted. We all understand that, so those of us that don't wish to get addicted avoid it. Also once you've quit smoking, you recognize that you can't start again, you can't do it "just a little bit," you'll get hooked again.
Well for alcoholics, that is how alcohol works. Most people, 90%ish, aren't like that. They do not get addicted. However for alcoholics it works like nicotine, they do get addicted. So the only answer is avoidance. There's no amount of time after which you are "cured" and can no safely drink, you just need to stay away.
Same thing goes for any addiction. You are never "cured" you just stop taking the substance. You can't ever go back to taking it, or you'll head down the path of addiction again.
It's a cult, plain and simple. But not all bad... (Score:4, Interesting)
My father managed to get out of several decades of drug and alcohol abuse (and criminality) via the 12 step. He got an education in treating addicts and now work since a number of years treating others with the 12 step. It works (but that's not news).
Seeing this pretty close and talking to my father about many details, I can state this with absolute certainty that it is 100% exactly the same as any "mind-controlling" cult, but for a different purpose. It works the same, looks the same, everything - and it even has a lot of "god" in it, although many people choose to interpret that in other ways. Especially it is formed to teach you that you are powerless and must trust whatever higher power. It turns the addicts into addicts for meetings instead of drugs.
I have many many problems with the treatment as it is done today, especially since it forms a life-long dependency on something new (this is the trick!) instead of the drug, and the breaking down of the mind. But, on the other hand, it's better than the alternative. I just can't help thinking that there must be a better way than switch addiction for addiction. My father disagrees, of course, simply because for him, this is not how he views it, he sees himself as free from addiction, but he gets all jittery if he can't go to a meeting for a few days...
If we are gonna reprogram humans (it's similar to NLP?), I'm sure it would be possible to reprogram them in a better way than this.
Re:An AA Alternative: Naltrexone (Score:3, Interesting)
There's also another alternative. LSD. It makes the person who takes it think more clearly and see their problems in a whole new light and make them accept that they have a problem as well as give them the will to stop.
I'm not an alcoholic, but I stopped smoking cigarettes after taking acid once. It suddenly made smoking seem so stupid. I already knew that it was stupid, but somehow the acid made me really think about how cigarettes hurt me and that gave me the willpower to stop. And that wasn't even the reason I took the drug. It just sort of happened while I was smoking a cig. If someone took it with the sole purpose of getting to grips with their addiction with the help of a therapist it would probably be even more effective.
Unfortunately LSD is a schedule I drug. Probably because it makes you think too much about things you shouldn't think about.
Re:quit drinking (Score:4, Interesting)
3/4th of people don't quit drinking after getting alcohol induced pancreatitis locally here, probably a big part of it is the shitty education on the subject - they're one of the biggest money drains on public health care over here, every intensive care ward has someone dying from symptoms caused by reoccurances of it. the education for it given? a fucking brochure about dangers of drinking and then you're sent home with a weeks dose of opiates.
I'm not an advocate for all people to stop drinking totally, just for people for whom it will cause serious medical problems that are not offset by the benefits of drinking and for those who are just so big douches when they drink that it causes them massive problems, that they view as massive problems(thus, again, damages outweighing benefits of fun) - in which case the solution is the same two step. however those douches are actually a minority, but you notice them much easier.
Of course if you have no reason to stop drinking - why would you embark on even one step program to quit drinking?
AA system sucks, hard. and that for most substances the society has built artificial damages for "abuses" of many substances - so they become a serious hamper on your life much, much before they become an actual problem on your functionality as a person or a problem on your health and that's stupid - with alcohol it'll for most people become a hamper on the health long before it becomes a problem socially.
Re:quit drinking (Score:5, Interesting)
Why is this modded down?
If you type "is AA" into Google, Autocomplete will give "is AA a cult" as the first suggestion. Their success rates are abysmal.
"Trying to fill the time" is an enormously important part of quitting the booze. The physical alcohol dependency quickly disappears, but your brains desire to kill some time by getting drunk never goes away.
It's very annoying when the best posts on Slashdot get nuked, while somebody theorizing (poorly) about quitting alcohol can get modded up to +5. When I don't have an expert opinion on a topic, I let other people do the talking ...
Re:More nonsense (Score:3, Interesting)
But to some degree, the one IS the other. And to the degree it isn't: Hospital patients regularly get physically addicted to opiates. They get much purer stuff than on the streets, and they actually get more addicted - they need larger doses to have an effect, and so on. Yet after going through painful withdrawal, these people never want to try it again - they're no more likely to become opiate addicts than anyone else.
There was a big study on Vietnam veterans, probably they expected to find the opposite. But people who had been treated with opiates during the war did no better or worse than other veterans.
Another thing is that if you meet a really long-time addict, odds are he would have gone through withdrawals many, many times the last years. Odds are also that he would have spent many weeks or months sober in periods, without help. Many, perhaps most addicts can decide to stay sober for a while if the situation demands it (for instance for special events like visits or trips). Yet they go back on the drugs.
People use drugs because they want to. Why they want to, currently psychiatrists are doing a much better job actually explaining than neurobiologists. It's just more practical to look at in human terms. Maybe it will change one day, but that's how it is now.
Re:It's a cult, plain and simple. But not all bad. (Score:5, Interesting)
In college, I attended an AA meeting as a requirement for a Psychology class. I wan't an alcoholic or even on the path to alcoholism; I just needed to fulfill the requirement and "attend an AA meeting" was the easiest way to do that.
The first thing I noticed was that all the people in the meeeting (there were maybe 40 attendees) had replaced alcohol with coffee and cigarettes. The second thing was that all of these people seemed to care about each other. A lot. It wasn't anything explicit or obvious; it just seemed to radiate from everybody and it generated this vibe that was incredibly warm and fuzzy. I didn't announce why I was there, so unless they asked me the other attendees just treated me like another anonymous alcoholic. And they treated me like I was their son or their brother. It felt really, really comfortable and nice. At one point, I actually thought to myself "it's too bad I'm not an alcoholic, because it would be great to hang out with these people every week."
I left that meeting on an emotional high. The only way I can describe it is that it was like finding out you had a whole branch of your family that been searching for you for years, and now you've been reunited and your new family just accepts you with -- not just open arms -- but with a tangible joy that you've finally joined them. It was awesome! And then I got about 50 feet out the door and said to myself "You just got hooked by a cult!"
I was shocked because I had always assumed that I was 100% absolutely immune to cults. I had read stories about people who were brainwashed into joining them and thought that I -- with my intelligence and my skepticism and my stable family life -- could never fall for something like that. But I had only been there for two hours and they had hooked me. Had I been less intelligent or cynical or more lonely maybe I wouldn't ever have realized what was happening.
But more importantly (at least for the report I had to write for my Psychology class), I understood how AA works. It's a cult. A brain-washing, mind-controlling cult that uses the same psychological techniques as Jim Jones or Heaven's Gate to control people, and then uses that control to help them conquer their addiction demons. It's atomic fission harnessed to light up a city rather than to destroy it. And it works because we're social animals and our brains normally respond to social cues at a level far beneath our concious thought. Unless we're actively guarding against it, we can all be manipulated this way. Even you.
Please note, I'm not in any way claiming that AA is bad or that they use social power to do anything other than try to help people. People's need for social interaction is just a fact, and AA uses this knowledge as the starting point to help people stop drinking. Knowing that you have several dozen people who care about you, who would be disappointed if you had a relapse, who look to you as an example of success, or who would be happy to talk to you if you just need help resisting the urge; that knowledge might make the difference between you giving in to your addiction and you staying sober for another day. That's a good thing and if AA works for somebody then that's great.
So I completely agree with AC's suggestion that AA is a cult; but I disagree that this is in any way a bad thing.
Re:How it works (Score:5, Interesting)
It trades one addiction for others: religion, caffeine, and nicotine.
It trades personal responsibility for not drinking, and thus drinking, to an imaginary higher power.
There is an athiest/agnostic sub-group of AA, but judging by things found on their FB page, they are having an uphill battle with the powers-that-be in AA.
https://www.facebook.com/pages/Agnostics-and-Atheists-in-AA/168374259840358 [facebook.com]
http://www.aa-atheists.com/ [aa-atheists.com]
Incomplete Research is Incomplete. (Score:5, Interesting)
There was an AA meeting group in the civic center I volunteered at. A loved one and friend of mine also attended AA meetings.
Though I am an atheist without a drinking problem I helped set up and clean up, and became tangentially involved with 12 step programs over the years.
One major compulsion to attend AA and other 12 step addiction programs, especially for teen and young adult members, is the unwritten "13th Step": Sex and/or relapse into addiction with other members. Some have related to me that they were introduced to hard drugs or "milder" drugs like cigarettes and caffeine via AA... When I asked if trading one vice for another wasn't just as bad (smoking packs of cigarettes a day is very bad and severely addictive), "One addiction at a time," they would say. One need only look at the coffee expenses nearly all AA meetings have to realize the effectiveness at combating addictions are quite subjective... A cyberneticist might even say: They have changed from sating their tendency via physiological addiction into sociological addictions, either can be severely harmful; Please enjoy addictions responsibly; Everything flows, moderation is the key.
I can believe that addictive personalties may favor a certain substance or habitual activity above others (drug of choice), but I can also acknowledge that there is no such binary as "AA works" -- It's more like: AA has some success and a lot of failures: Success more likely only if you've "Hit Rock Bottom" first however, which I find quite ridiculous. Either it does or doesn't work, the belief in AA that a cathartic event that nearly destroys a person be practically a prerequisite for recovery is dangerous, reckless, and foolish -- Not based in empirical study, for certain; Only anecdote.
There was a teen 12 step program my friend was in, "Lifeway", and "PDAP", before that. These were largely modeled after AA's 12 steps, but Lifeway mushed the "you believe in a higher power" in with some other step so that it could squeeze in a step about abandoning your friends since they will cause you to fall back into addiction again... Even abandoning me because I wasn't "a winner" in life enough to help my friend "work a program". This is a common cult tactic.
The safety net gone, when my friend could not "work a program" due to being as atheist and thus incompatible with the "higher power" step, my friend's parents (upon advice from the parent meetings they attended) kicked my friend out of the house. They said the other families wouldn't let them stay with them, even though such was the apparent practice, and instead they were shown, "Tough Love". My friend became a 16 year old homeless person and flunked out of high school. My friend said they still attended the meetings, because they were too ashamed and afraid to contact an old friend like me -- they said that if the group, family, or "sponsor" found out about the contact it could mean prolonging the homelessness. Though they had been without drugs while failing to "work a program" for over a year, they started using drugs again once on the street... Of course! That was my friend's first encounter with harder drugs... This before the 3rd step of the program could even be attempted, they said.
AA and other 12 step programs do not provide the housing aspect a teenage kid requires to survive, so they were of no help, "Keep coming back, it works if you work it," is the literally ignorant motto. After months of homelessness and abject prostration before the parents of Lifeway my friend was allowed to stay with another family, but not their own family; It was more "Tough Love" they said. I saw my friend with the new family around town and was quite puzzled because they'd never hung out before, and I was given the cold shoulder when I tried to say Hi.
Later, my friend had said they had to earn back the right to live in their home, and couldn't take any chances... Meanwhile they were instructed to attend "outpatient" meetings, which my friend described as exp
Re:Gotta have a plan (Score:5, Interesting)
If you are a logical person and want to feel your circuits frying go to a meeting and listen to the cognitive distortion-fest. If you stay away from alcohol it worked. If you don't then you failed, not AA. It is akin to a twist on Lisa Simpson's Tiger Repelling rock: It keeps away tigers. If you get mauled by a tiger then you weren't using it correctly.
In AA you need to be open minded, which means believing what they believe. If you don't believe what they believe, then you aren't open minded!
You need to get a "Higher Power" which, despite the claims to the contrary, is clearly and unquestionably the Christian God if you bother to read the literature. (e.g.. Tradition 2: "For our group purpose there is but one ultimate authority—a loving God as He may express Himself in our group conscience
Don't get me wrong, I'm friends with lots of "AAs" (as they call themselves in the literature, etc.) but one thing is for sure: Their imaginary friend did not restore them to sanity (see step 2).
These people almost killed me, and I am estranged from parts of my family to this day even though I turned to more powerful paradigms and overcame my issues once I finally rejected it and sought them (i.e. Yoga, Kundalini Meditation, and other spiritual but non-religious pursuits such as playing the guitar and listening to music, surrounding myself with non-drinkers, etc.) My family was told that if I wasn't in AA then I wasn't commited to overcoming my addiction, so in their minds I haven't changed so there is no sense in talking to me.
Luckily I am strong willed enough to have finally rejected their philosophy. As far as I am concerned AA may well have helped a lot of people, but it killed a lot them as well. The jury is still out as to which way the meter's needle sways.
Re:service to my fellows (Score:5, Interesting)