While I can understand the criticisms of Alcoholics Anonymous (AA) and other 12-step programs, a recent study that I stumbled upon suggests that for people wanting to achieve sustained abstinence from alcohol use, increased AA meeting attendance yields positive results. That is, increasing attendance of 2 AA meetings per week yielded 3.3 extra days of abstinence per month. These results suggest that both treatment providers and non-clinicians may find benefit in referring to AA for those with an addiction to alcohol.
However, there are those who have tried AA and found that its emphasis on a “higher power” give it an almost religious tone. This religious tone can be a turnoff and deter people seeking recovery from attending AA meetings. As a treatment provider, I do think that finding and emphasizing that which is sacred to a person can be a great benefit towards overall health. But, I also think that religion can be a disaster and do far more harm than good. Because I do recognize the potential for AA to become “religious,” I tend to tread lightly before I suggest that a client attends AA meetings. I also don’t like the use of terms like “alcoholic” or “addict,” as I have little doubt that those labels are not neutral and act as self-fulfilling roles.
But evidence is hard to ignore, especially evidence that is both statistically prepared and statistically significant. In light of that evidence, I can see how AA attendance can aid as part of an overall recovery program. The authors of the study do postulate that AA’s efficacy can be attributed to, “many processes generally found to be therapeutic, including social support for health behavior change, dry friendship networks, opportunities for altruism, the availability role models, instillation of hope and practical skill teaching.” These things, especially social support, do provide great aid in achieving and maintaining sustained recovery.
Therefore, because of the importance of recovery peer-support, I recommend that people seeking abstinence and recovery (they are different) do attend some sort of 12-step program. If not AA, then perhaps, SMART Recovery, Secular Organization for Sobriety, or LifeRing can be options. Breaking patterns of behavior and finding groups of people who don’t use drugs or alcohol is critical to recovery. If a person chooses to maintain the position that he or she can achieve recovery on his or her own, I would argue that that person is maintaining a selfish mentality that probably contributed to his or her addiction. AA (and other social support groups) can be a great resource in achieving both abstinence and recovery.
January 2, 2016 at 11:34 am
I was moving out of my agnostic 20’s when I first started going to 12 step meetings and cringed when I heard them say they were not religious, but then said the Lord’s Prayer at the end of the meeting. It helped when I heard a woman next to me say, “Our Creator…” instead of “Our Father.” I still do that sometimes. Fortunately there are meetings where a prayer associated with a specific religion is not said and where tolerance of diversity is growing. It also helps that are all those other alternatives you mentioned. I have noticed, over my 30 years as a counselor, that most of my “successful” clients go to 12 step meetings more than once a week and work the steps with a sponsor, so I’m not at all surprised by the evidence in this study.
January 3, 2016 at 9:03 am
THANK YOU for actually reading the post and commenting from from your experience in terms of the post. I appreciate your perspective and sharing your experience — it’s quite valuable!! thank you !!
January 2, 2016 at 3:51 pm
I get the perspective and intent of the article but I feel that many industry professionals, including the author, are more caught up in the 12-step ideology than they realize. To say that “its emphasis on a “higher power” give it an almost religious tone” is an understatement. There are religious analogs that permeate 12-step culture that are way more than “almost religious”.
Spiritual Indoctrination by means of the following:
• Surrender to a “higher power”. Looking to an external, mysterious and supposedly sentient force that governs an individual’s life.
• Prayer. Prescribed and scripted individual and group prayer.
• Sponsorship. The idea that another person with more sober-time can be a guide or mentor.
• Confession. The belief that speaking one’s transgressions to another person somehow absolves the transgressor.
At face value, none of these components are in and of themselves negative or lacking in value. Unfortunately, if you introduce them to a peer-run group of individuals that unquestioningly, cling to legacy traditions and dogma, and who have a variety of mental disorders, many of whom are being told to treat these disorders with a spiritual practice, you can easily understand the propensity for these practices to be exaggerated and abused.
The author goes on to say, “I recommend that people seeking abstinence and recovery (they are different) do attend some sort of 12-step program” and then names a number of secular recover organizations. None of those listed are 12-step programs and the use of “12-step” as analogous with peer-focused support organizations is misleading. 12-step is it’s own genre and should not be confused with secular support or other organizations.
Then the individual that maintains the position that he or she can achieve recovery on his or her own is called “selfish”. This plays in directly with the 12-step tendency to label behaviors as “character defects”. It concerns me that so many recovery professionals buy into this theory. It only seems logical to me that a person displaying this behavior is not proud or flawed. On the contrary, they appear to be reacting out of fear, and would be much more receptive to an offer of support as opposed to a label shaming them.
It would be foolish to argue that 12-step is not beneficial to many. That said, my issue with 12-step and much of the professional recovery community is the insistence that since it is effective for some, it must be effective for anyone who has a desire to achieve “real” sobriety. The failure to succeed in a 12-step environment is portrayed as a moral deficiency. Incompatibility with the ideology is seen as inability to grasp the basic concepts or even worse the “selfish” belief that what works for one individual may not be effective for another.
Indeed, studies show that 12-step attendance is statistically better than no support. That is not at all the same as saying that it is the most effective or by any means, the one-size-fits-all solution that many try to make it. The same can be said for any addiction support modality. There’s nothing wrong with 12-step for those that choose it. It seems irresponsible however, to imply that it is a good fit for most people.
January 3, 2016 at 9:02 am
Hello — I do stipulate that AA or other 12-step programs aren’t for everyone. The article and my review both state that the operating variable that works within AA is the social support aspect. I think people should find health BY ANY AND ALL means necessary and if AA can work for some, then some should attend. But addiction is a disease of isolation and support is key to disrupting that isolation. Thank you for the well thought our comment!