The Perfect AA 12 step program.

The Perfect  AA 12 step program?

I think anyone who has looked at other pages on the site, will realise I do not have much time for the 12 step AA program, which I consider to be ineffective and out of date. I feel that a lack of alternatives in the past and the evangelical nature of some AA members, has caused it to grow, rather than the efficiency of the 12 steps. The big book which is the text that describes the AA program was produced before World War Two and has not had a serious update since then. This was around the same time that Penicillin was invented, and was considered cutting edge. The medical world has moved on since the 1930’s and has embraced many new ideas for treatment but AA has stayed in the past and does not have leadership that will embrace change.

This is a great shame as AA and the 12 step world have the potential to help so many as they have a large infrastructure. This was helped by the fact that many members are quite evangelical and often went to work in treatment centres, where they pushed the 12 step idea that had worked for them. I don’t deny that this approach has helped some, who seem happy to pray to a higher power and practice the steps, but in reality many people find the 12 step approach to be ineffective and others are actually harmed by it. Many just take a look at the scrolls hanging up at a meeting, and leave, without being offered suitable help.

I can’t think of another area of medical treatment where a one size fits all solution is relentlessly pushed, in-spite of a lot of evidence, that it has no real effect on the numbers that succeed in beating addiction using that method. The 12 step program of AA is often held up as faultless, by its devoted members and should somebody fail, and go back to drinking for a while (most do), then the individual is blamed. In my experience, AA members would not consider advising a member who fails regularly and relapses, to attend another program. This would not cross their mind, as for them, it is AA or nothing. They consider anybody who is not working their program, to be a dry drunk, which is rather condescending. I am not saying that everyone who stops drinking without AA is completely sane, ( try going on certain anti AA forums! ), but AA members who have attended for some time, start to behave in a similar fashion and will often use AA phrases as often as possible when they talk. This is what they consider sobriety. This makes them appear rather quaint to normal people, although you could argue that the fact they have adopted this eccentric lifestyle is what has saved them. You do need a pretty big shift in attitude, if you want to get sober, I just don’t see the AA version as something I would want.  I aimed “to cross the bridge to normal living” ( an AA phrase) rather than get stuck on it with a load of 12 steppers. The odd phrases and customs along with the love bombing, gives a cult like impression to many.

Chapter 5 of AA Big Book

Chapter 5 is the part of the Big Book where the steps are introduced to the members of AA that actually read the “Big Book” . It starts with this :

“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… They are naturally incapable of grasping and developing a manner of living which demands rigorous honesty.”

I used to cringe every-time this was read out in meetings, as it puts the blame for lack of success in what is a faith healing treatment, in the hands of the poor individual who has suffered. I can’t think of another area of treatment where this would happen. Imagine telling a cancer patient that it is their fault that chemotherapy did not work for them or any other “chronic disease”. I feel this paragraph undermines the credibility of the 12 step program, more than any other part of the “Big Book” .

It is quite often the case that more than one treatment is tried for chronic illnesses, I have asthma, which you would think would be pretty simple to deal with, but even that, improved when my treatment was modified over time.  I was certainly not told that it was a lack of rigorous honesty, that caused limited progress, with my initial treatment.

A successful outcome to working the steps seems to be dependant on an individual being saved by God. Only the AA program seems to be able to guarantee this and it only seems for addiction problems. For instance, God does not seem to have a great success rate curing amputees, many of whom, are probably quite religious.  AA is pretty much the only place I have been that seems to be able to predict what God is going to do. They seem to think that they can guarantee God’s actions and that all members will be saved by following the steps, even though many fail. If you bring this up in a meeting (I did in a large Sunday morning one), you will be met with ridicule. AA meetings are not the place to express concerns about the methods in the Big Book. This type of response is often found in religious groups.

Never the less, many in AA will not have a word said against the program, and firmly believe it is the answer to all problems with alcoholism, irrespective of the background or circumstances of the individual. I think that using the 12 steps as a treatment would be about as much use as using faith healing for my asthma. The medical world has moved on since the Middle Ages in most areas. The real tragedy is that the inflexibility of those who effectively run AA, has meant that the method has never been seriously updated, or any worthwhile new literature produced. It means that many who join AA thinking they are going to find a solution, never get to hear about medication, that may help them. AA meetings never sell any literature that mentions any other methods. I presume this is because they are worried that most newcomers would simply leave, or it could be that they would not make as much money from selling other publishers material, which was once given to me as a reason.

This is all rather sad, as it results in many people persevering with a method that does not really suit them. Especially if they have a rather overzealous step obsessed sponsor, who probably has very little concept of any alternatives themselves, which was my experience. I do feel things are starting to change. The internet has made a wealth of new information available for anyone prepared to look and many are. There are blogs popping up all over the place and people from all over the world are linking up to communicate ideas that have worked for them. There are also a wide range of modern books that can be found on sites such as Amazon which can really help you find a suitable solution.

The thing that AA can offer is fellowship. Face to face contact with others who are in a similar position can be really motivating for some. Quite a few people have destroyed their lives by the time they come to stop drinking and some attention from kind people will probably do them some good. I think this is the main thing that AA has had going for it over the years. AA members, tend to say the steps are what saved them, when in reality being part of a group probably helped more. This was really the only part of AA, that I feel had any use for me, I hated all the higher power stuff and was not comfortable discussing my life with a sponsor at all. I don’t think other groups are big enough yet, to offer as many meetings through the day, where people can turn up and talk to another.  However, they do offer online meetings which are more convenient for many, and also being safer.

Having said that, I have seen quite a lot of people (mainly women) on the soberistas site say that they did not want to go to AA meetings at all and it does not look like many have looked for much in the way of alternatives. For many of these women, a program aimed at low bottom male drunks written in the 1930’s would be of limited use. They need support and help with self-esteem. The site does offer that and is well moderated, and people with extreme views are not taken seriously as they would be on some pro or anti AA sites which are often full of unbalanced people, although of course there are exceptions to this and I have linked to many of these sites, who are there to highlight dangers within the 12 step world.

I think online communities could be the answer for many in the future. They are hard to get going and do need serious moderation otherwise they very quickly turn into unpleasant places dominated by cranks, that should be avoided by most (unless you just want to laugh at them and their bigoted views!). They have the advantage that they can run 24 hours a day,so people can drop into chat rooms whenever they want. You can be more anonymous on these sites than it is possible in groups such as AA and they are suitable for people with young children or those who live outside cities. You can meet like-minded people in any part of the world.

I was quite shocked by the amount of gossip that went on in AA. I discovered that my sponsor would talk about the things that other sponcees were doing. His life was AA, he did not do much else and when I look back, I realise he was a pretty sick individual, but also a master manipulator. For him, chapter 5 was the answer to everything in his limited world, and I believe he turned a huge number of people off recovery. I was one of the lucky ones that saw through AA and was able to move on. Others became trapped in a cycle of relapse and then redoing the steps – often with tragic consequences. It is early days for sites such as the soberistats and I feel it will take a decade, to really see how successful they are long term, but they have certainly come up with something new and dynamic which attractive to a wide range of people and that is a really good thing. I believe others could use the model and build similar groups if some sensible people are able to put something together.  I would imagine that the soberistas site actually attracts more new people than AA in the UK now, so it may make AA take a look at itself, do a step 4 and ask for some help! People may start to share about other methods that have worked for them in meetings.Some are using both and this could be a really good thing, as it could counteract some of the dogma, in the long-term.

It takes time to change opinions about something that many see as helpful, but the reality is that AA does not publicise the failures and blames the individual when they happen. It is important to learn from the past but not good to get stuck in it. Recovery groups need to look at changes in culture and modify their approach if they are to be effective. There is too much faith healing and mumbo jumbo in the recovery world and not enough people pushing for change. The boundaries between a support group and treatment have caused a lot of confusion as AA has become a dumping ground for the courts and a free solution to aftercare for some rehabs that realise that many patients are customers who will keep coming back! A religion can offer fellowship and support, but it is not a treatment for a medical condition, even for a disease that does not exist. If you like it keep going, but I don’t think it is fair to run rehabs that simply rehash the steps and take people’s money, tell them they are powerless and wait for them to relapse and come back to spend more.

AA has often been criticised in the past even by its own members, but very little seems to change. Here is an early example of a critical member http://www.silkworth.net/magazine_newspaper/harpers_magazine_feb_1963.html

I was not really that suprised to find AA  and 12 step was not considered to be the best solution when methods were compared but was not expecting it to be 37th and 38th out of a posssible 48 in this book http://books.google.co.uk/books/about/Handbook_of_alcoholism_treatment_approac.html?id=LHlHAAAAMAAJ&redir_esc=y

If you like holding hands and saying the serenity prayer then it may help you, but I would urge others to look at alternative methods as well if you really want to het well and avoid the often dreadful relapse. Good luck which ever way you choose.

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  1. Thanks for a great entry. I liked your penicillin analogy, while back when AA started penicillin was indeed a miracle drug that saved lives, now it’s overuse (along with other antibiotics) has created a dangerous situation where it is no longer effective, and it’s continued overuse makes it even more ineffective, and even more dangerous, just like AA….unfortunately it is so firmly entrenched that it is going to really take a lot of effort of the part of many people to move forward with alternatives. I am looking at online meetings at SMART Recovery for myself, and am thinking that if I like them I may apply to the facilitator training and start a group in my town. It’s going to take people willing to challenge the AA dominated status quo to change the face of recovery.

  2. I’m actually allergic to penicillin! It is not just AA. At least penicillin did work for most people!

  3. I have read a lot online about how ineffective AA really is. This article though reinforces something that I have been thinking about for some time.
    If AA would just accept change (do away with the 12 Steps, and some other ways they do things), it would be a much more effective support program

    • You know I have thought the same thing. I do not see then changing though and it really is too bad because thy have the footprint and infrastructure. I think if the average person was told that AA updated their program, most people would think that makes sense- of course! But AA I do not think ever will.

  4. I do think they need to ackowledge that there are quite a few developments in the field of recovery. Fellowship is an important part of getting well but I think that the way many focus on the steps can be be quite limiting fort them.
    It is hard to work out exactly how ineffective AA really is because some people are sent to it when they don’t want to go, and others want a reduced prison sentence etc. I think groups like Smart will also get people who are a bit more committed as they are harder to access, so those that do go there are making quite a big effort. I used AA as a place to go to break the habit of going to the pub etc but after a while I questioned the literature and methods. I also had a major breach of privacy which was the final straw for me. I did learn to ask for help in AA, but found it more effective to ask for help elsewhere! I think meetings are unbalanced in many places as people who have got better tend to move on leaving people who are fans of the steps behind. They tend to dominate meetings, especially in larger city meetings that can be quite large.As a result, less people get the type of help that would really be useful.
    I am reading Stanton Peele and Ilse Thompson’s new book Recover http://www.peele.net and think it would help many who are not suited to a spiritual 12 step solution. I think that trying to impose a solution on an alcoholic in the way AA does often creates problems and a lack of progress.

  5. Rowland Cheatham February 7, 2014 at 2:45 am · · Reply

    I’m experiencing the freedom that comes with having let go of a major source of suffering for me. AA/NA, the meetings. the steps, hanging out with recovering types afterwards that left me wanting, the slogans…most of all the stark realization that a placebo was being consumed. But rather than a sugar pill, it was a capsule full of rat poison known as the steps. Don’t hesitate…walk away…today.

  6. I was going to some meetings that were really quite cult like when I left where I was told do this or you will relapse and die. I was lucky that I had friends who had left, and I could see they were doing well. Here is a piece by somebody else about a group I went to. http://www.aacultwatch.co.uk/2012/03/year-or-two-with-joys-of-recovery.html

  7. Hi tovebird! I am a big fan of SMART Recovery and their online meetings. If you use them let me know what you think. We certainly need more facilitators out there too, so that would be great for you o become a facilitator in your area.

  8. The wierd thing about the program is that in can serve as a means to ego-boosting for some people, who really just needs a simple ego check ( not an ego – eradication as AA and a lot of other failed spirituality suggests, which is, of course, utterly impossible). Coming to AA as a drunk oftentimes means that you have failed in the areas of life youre supposed to succeed in. Work, relationships, academia, financially, societal status etc.

    Yes its true that wanting success in those areas of life belongs to the realm of ego. But thats not a problem, its a good thing. It become problematic when there is an emotional need for superiority in those areas of life. When its not enough with “just” being good at what you do, or “just” being liked by your friends and lifepartner. When you feel that you as a person is a failure with “just” one car in the garage or “just” getting a medium sized paycheck from your work each month, that these facts make you as a person feel inferior, worthless not loved etc.

    Failure in these parts of life acts as a tormenter on people with big egos ( that is, egos with a need for superiority ). These egos will in fact never succed in life. Its not possible, not even when they give up the sauce. Since all it takes for these guys to feel like a complete failure is one critical remark on their behaviour or opinions from someone.

    AA steps in as a saviour for these egos in that, that the steps is then seen as an easy accessible and quick way of succeding in another, possibly forgotten, area of life, the spiritual area. The twelve steps is firstly of course seen as superior to any other spiritual or religous program. It offers the practioner a means to gain a so called “spiritual awakening”. The ultimate gold medal. From the seat of a spiritual awakening ones failures become bearable because now you acheived the biggest achievement possbile. Youre spiritually awake, in councuous contact with God. Youre up there with Jesus and the Saints. This delusion gets reinforced by you chairing meetings, having a bunch of sponsees, who regard your words as gospel, people in the Group look up to you since youve been sober for 5, 10 or 20 years etc.

    Once in this bubble of delusion, its nearly impossible to get out. You become truly blind to your own bullshit-behaviour. Your own bullshit-behaviour is no longer you even, its “the self” or the “devil” trying to get control over you. Wich is remedied by more stepwork, You become fake in your interactions with other people, people you feel yourself superior to. Now you need the program just as much as you once needed alcohol. Without it youre lost, having to be confronted with reality and your own true place in it. The program never gets to the core of your problem, wich is “the emotional need for ego-superiority”.

    Its really not a thinking problem wich can be corrected by adhering to a set of principles, its an emotional problem wich needs to be dealt with on the level of emotions. All therapy can do for a person with an ego like this, is helping him/her see it. In order to brake free the person just has to go trough a shitload of emotional pain, quite similar to the pain of withdrawal when laying of the sauce, altough less physical and more emotional.

    The twelve steps is of course alluring to alcoholics with an ego as described above, and might help explain why there is such an abundance of lying, egomanical fundamentalist oldtimers in the fellowship. Its founder mr Wilson, having a big ego problem himself, never snapped out of it through the means of the twelve step program, even his therapist pointed out that his involvement in the program might be adding to his problems in life.

  9. I think you are right and so many people that stay in the program enjoy controlling others. For them it is their way or no way. Thanks for such a detailed comment!

  10. There no such thing as PERFECT that is Drug Treatment offers different kinds of treatment customized to each patient allowing the best solution for each customers to be use not just the ones that we use to know.

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