Wednesday, March 26, 2014

Not A Cult. Not A Religion. Not Science.

It's way past time someone did it.  And in this excerpt from "The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry,"  Zachary Dodes and Lance Dodes,M.D. debunk,well, 12-step programs and the rehab industry (which as the "rehabilitation" industry would be far less fashionable).  Studies, Dodes & Dodes maintain, have shown Alcoholics Anonymous successful in effecting sobriety and preventing relapse in only 5-10% of cases. Nevertheless,

AA has managed to survive, in part, because members who become and remain sober speak and write about it regularly. This is no accident: AA’s twelfth step expressly tells members to proselytize for the organization: “Having had a spiritual awakening as the result of these Steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.” Adherence to this step has created a classic sampling error: because most of us hear only from the people who succeeded in the program, it is natural to conclude that they represent the whole. In reality, these members speak for an exceptionally small percentage of addicts, as we will see.

The Dodes Boys note the religious antecedents of the organization, whose 12 Steps include references to alcoholics as "powerless," to "a Power greater than ourselves," to a "spiritual awakening," and in five instances, to "God."  The authors criticize an "emphasis on proselytizing, a basic tool through which recognized religions and certain fringe religious groups spread their message."

But it is not clear to what "God" AA is referring, or even if they're referring to a God recognizable to adherents of any of the three great monotheistic religions (Christianity, Judaism, Islam), one of which accepts the Old and New Testaments, one the Old Testament, and the other portions of the Old Testament. Alcoholics Anonymous, by contrast, asks its disciples to submit to "God as we understood God."

That is what in law, economics, and common English is known as a giant loophole. "God" is neither defined nor described, a convenient concession to the Great American Religion in which we all believe in a god, whatever he, she, or it might be, lest there be no way we get into heaven and no supreme being approving our every move.

AA does proselytize, but it has nothing to do with religion, aside from a generalized, undefined, ephemeral spirituality.  Dodes & Dodes explain

Beyond these individual proselytizing efforts, AA makes inflated claims about itself.  Its foundational document, Alcoholics Anonymous (commonly referred to as the “Big Book” and a perennial best seller), spells out a confident ethos regularly endorsed by AA members:

Rarely have we seen a person fail who has thoroughly followed our path. Those who do not recover are people who cannot or will not completely give themselves to this simple program, usually men and women who are constitutionally incapable of being honest with themselves. There are such unfortunates. They are not at fault; they seem to have been born that way. They are naturally incapable of grasping and developing a manner of living which demands rigorous honesty. Their chances are less than average. There are those, too, who suffer from grave emotional and mental disorders, but many of them do recover if they have the capacity to be honest.  

Evidently, AA doesn't require of itself the humility it appears to encourage in its clients.  "The program," the authors summarize (emphasis theirs) "doesn’t fail; you fail."  AA escapes characterization as a cult because it lacks deviant views. Its approach not only has become widely accepted, it has crowded out other, more verifiable and scientifically sound approaches. Unsurprisingly, then, Dr. Dodes writes

I have been treating people suffering with addictions in public and private hospitals, in clinics, and in my private practice for more than thirty years. In that time, I have met and listened to a very large number of people who have “failed” at AA and some who continue to swear by it, despite repeated recidivism.

As men of science, Dodes and Dodes cite AA as reflective of a rehabilitative industry that promises, and claims, far more than it delivers.  The twelve-step concept, however, does successfully deliver a warm, fuzzy feeling which many people, whether or not addicts, find alluring.  The industry, as the Dodes outline, resembles a pseudo-science.  Paradoxically, however, it simultaneously (at least in its twelve-step focus) resembles pseudo-religion. Neither Jewish nor Muslim (nor polytheistic), it also is unfaithful to the monotheistic religion, which in its jarring testimony, is far better exemplified here by the late Odetta:

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