by Chaz Bufe, author of Alcoholics Anonymous: Cult or Cure?
Alcoholics Anonymous (AA) is, arguably, America’s most sacrosanct institution. Its promoters (often AA members hiding behind “anonymity” while they promote AA) present it as an unalloyed good: effective, “spiritual not religious,” supportive, nonjudgmental, purely voluntary, based on “attraction not promotion,” and leading to personal growth (being “better than well”). Some even state that AA has no negative aspects whatsoever and that AA with it’s 12-step approach is the only effective approach to addictions problems.
All of this is wrong. The rate of recovery via AA is no greater than the rate of spontaneous remission. AA was part of a Protestant evangelical group for the first several years of its existence, and its 12-step program is blatantly religious by any reasonable definition of the word. AA is supportive–as long as you parrot its party line. It’s nonjudgmental–again, as long as you parrot the party line. AA is not purely voluntary; over a million Americans per year are coerced into attending it via court orders and employee assistance programs, as a condition of avoiding jail or keeping their jobs; and many of AA’s promoters insist that AA doesn’t promote itself, even as they do exactly that. As for AA members being “better than well,” attend any meeting and see for yourself. And AA does have serious negative aspects, both for its members and those merely exposed to it.
I’ll deal with all of these topics in a series of upcoming posts. Let’s first look at the harm AA does to its members, those who come to it voluntarily for help, and those who are coerced into attending it.
Even for the small percentage of attendees for whom AA “works” (approximately 5% according to AA’s own triennial surveys–roughly the same as the rate of spontaneous remission), there are negative effects. The first of these is that many AA members adopt “alcoholic” as their primary identity. They identify their very beings with a past, self-destructive behavior. They stay stuck–focused on the past. It’s both strange and sad to see someone who hasn’t drank for twenty years identify him or herself as an “alcoholic.”
(What would we think of someone who gave up cigarettes twenty years ago, yet still identifies him or herself as a “smoker”? The only reason it doesn’t strike us as equally strange for long-time nondrinkers to identify themselves as “alcoholics” is the constant self-referential use of that term by AA members. Endless repetition desensitizes us to the strangeness of this very odd usage.)
Another negative aspect of AA is that it keeps members dependent upon it. According to 12-step dogma, “alcoholics” are always “recovering,” and that the only way they can maintain sobriety is to attend AA for the rest of their lives. The way my late friend Vince Fox defined alcoholism and 12-step alcoholism treatment neatly encapsulates the 12-step approach: “Alcoholism is a phenomenon characterized as physical, mental, and emotional, and treated in medical settings by nonmedical personnel with a religious program in which the patient is admitted as diseased, discharged as diseased, permanently recovering, and never recovered.”
So, AA members consider themselves “diseased,” adopt the “alcoholic” label as their identity, and (at least in theory) remain dependent upon AA for life. Many “old timers,” who have been sober for twenty or thirty years, still go to several meetings per week, some daily. This, of course, is a severe time drain. The amount of time wasted by American AA members on AA meetings is probably second only to the amount of time wasted in the U.S. by Mormons–in another lifelong “program”–on LDS meetings.
Another major downside of AA for its longtime members, those who come to it for help, and those coerced into attendance, is AA’s insistence that “alcoholism” is a “progressive disease,” that drinking inevitably worsens barring abstinence, and that “alcoholics” have no control once they start drinking–that their only alternatives to AA are “jails, institutions, or death.” Leaving aside the absurdity of labeling a behavior as a disease, all of this is simply wrong. (More on this in a future post.) But for those who buy the assertions that drinking inevitably worsens and that they have no control, the results can be serious. These pernicious assertions often becomes a self-fulfilling prophecy. Other AA assertions–notably that, according to AA’s “Big Book,” alcohol is “cunning, baffling, powerful!” and individuals “powerless”–only exacerbate this problem. So, when AA members start to drink, they think they have no control, so they don’t even try to control their drinking–they binge.
Research seems to bear this out. What is still probably the best scientific study of AA’s effectiveness (Outpatient Treatment of Alcoholism, by Jeffrey Brandsma, Maxie Maultsby, and Richard J. Walsh, Baltimore: University Park Press, 1980) reported that those assigned to the AA group (with its “one drink, one drunk” dogma) binged more than four times as often as the no-treatment controls.
As well, since AA meetings are so unattractive that only (again according to AA’s own triennial surveys) five percent of those who “walk through the door” are there a year later, millions of people have been exposed to AA’s pernicious assertions and, at least in some cases, their drinking likely worsened as a result–and many undoubtedly don’t even try to find alternatives, because of AA members’ insistence that AA is the only thing that works. (Again, this is totally wrong–there are more effective alternatives. More on this in a future post.)
These are only the most obvious negative effects of AA upon those exposed to it.