Posted on 03/23/2014 4:04:01 PM PDT by nickcarraway
Since its founding in the 1930s, Alcoholics Anonymous has become part of the fabric of American society. AA and the many 12-step groups it inspired have become the country's go-to solution for addiction in all of its forms. These recovery programs are mandated by drug courts, prescribed by doctors and widely praised by reformed addicts.
Dr. Lance Dodes sees a big problem with that. The psychiatrist has spent more than 20 years studying and treating addiction. His latest book on the subject is The Sober Truth: Debunking The Bad Science Behind 12-Step Programs And The Rehab Industry.
Dodes tells NPR's Arun Rath that 12-step recovery simply doesn't work, despite anecdotes about success.
"We hear from the people who do well; we don't hear from the people who don't do well," he says.
Interview Highlights
On Alcoholics Anonymous' success rate
There is a large body of evidence now looking at AA success rate, and the success rate of AA is between 5 and 10 percent. Most people don't seem to know that because it's not widely publicized. ... There are some studies that have claimed to show scientifically that AA is useful. These studies are riddled with scientific errors and they say no more than what we knew to begin with, which is that AA has probably the worst success rate in all of medicine.
It's not only that AA has a 5 to 10 percent success rate; if it was successful and was neutral the rest of the time, we'd say OK. But it's harmful to the 90 percent who don't do well. And it's harmful for several important reasons. One of them is that everyone believes that AA is the right treatment. AA is never wrong, according to AA. If you fail in AA, it's you that's failed.
On why 12-step programs can work
The reason that the 5 to 10 percent do well in AA actually doesn't have to do with the 12 steps themselves, it has to do with the camaraderie. It's a supportive organization with people who are on the whole kind to you and it gives you a structure. Some people can make a lot of use of that. And to its credit, AA describes itself as a brotherhood, rather than a treatment.
So as you can imagine, a few people given that kind of setting are able to change their behavior at least temporarily, maybe permanently. But most people can't deal with their addiction, which is deeply driven, by just being in a brotherhood.
On a psychological approach to addiction
When people are confronted with a feeling of being trapped, of being overwhelmingly helpless, they have to do something. It isn't necessarily the "something" that actually deals with the problem ... Why addiction, though, why drink? Well, that's the "something" that they do. In psychology we call it a displacement, you could call it a substitute ...
When people can understand their addiction and what drives it, not only are they able to manage it but they can predict the next time the addictive urge will come up, because they know the kind of things that will make them feel overwhelmingly helpless. Given that forewarning, they can manage it much better.
But unlike AA, I would never claim that what I've suggested is right for everybody. But ... let's say I had nothing better to offer: It wouldn't matter — we still need to change the system as it is because we are harming 90 percent of the people.
And me for almost 4 years.
There has been a long history of “psychologists” being very anti AA, they favor so many other treatments, such as Rational Recovery. Their two biggest problems with AA is that it encourages a Higher Power ( and psycholgists like to think of themselves as the higher power.ha) and that it is not “therapy”.
This clown obvioulsy has not studied AA as nowhere does it say it is THE ONLY way to get and remain sober, in fact, AA says if you can stay sober another way, go for it. Failures? The whole problem of addiction has high relapse rates, and some people may have to try recovering again and again.
But the most hilarious aspect of his “theories” is his incredibly flawed “research”. Any psychologist in his first year of school would know it almost impossible to do the rigorous, quantitative evidence based, double blind research that a valid protocol demands because AA does not keep records of its members. HA. HA.
So Mr.brilliant PHD, keep writing books, make some money in the rehab field, hit it out of the park in Academia where everyone already agrees with your hypothesis!
Not everyone who comes to AA for the first time wants to quit. Many of these are those who come for back problems. They want to get the wife, the boss, or the judge off their back. They are not interested in staying sober.
It is an axiom of AA that everyone has to hit their own personal bottom. Only then will they be willing to do the personal housecleaning that is necessary to stay sober.
I almost died of acute Pancreatitis on my 51st birthday. It was stop drinking or die. No ifs, ands, buts, or maybes. I didn't want to die and didn't know how to not drink. AA helped me when I couldn't help myself. Eight years later I am still sober.
AA is not for those who need it. It is for those who want it. Those who want it bad enough will learn and stay sober. After a time they will then be able to help the next new person who comes in asking, "I don't want to be drunk any longer. What do I need to do to stay sober?" Those people we can help.
Anyone CAN follow the AA program. Not everyone WILL follow the program.
Garde la Foi, mes amis! Nous nous sommes les sauveurs de la République! Maintenant et Toujours!
(Keep the Faith, my friends! We are the saviors of the Republic! Now and Forever!)
LonePalm, le Républicain du verre cassé (The Broken Glass Republican)
all it takes to quit is to decide to quit and do it.
People that can’t quit, don’t want to.
I agree. Court ordered rehab is a waste of time and money. You have to decide you want to quit and then it is possible. Until than it’s all for show.
Thank you for your testimony.
My question is, why change AA at all? Leave it alone for those it works for, let the rest find whatever works for them. Why risk creating another Obamacare like fiasco because “some” folks think they’ve somehow been “harmed” by it?
You nailed it.
I do not want to be drawn into an argument, since I do not have the time. But I am writing on the small chance that I can help someone.
But for those of you who support AA, research has shown that the disease theory of addiction that AA promotes is one of the most harmful things possible in recovery. Even for people who are not in AA, studies show that believing in the disease model is a strong predictor of failure.
This does not mean that all critics of AA are atheists. In fact, the AA mantra that one is powerless to beat their addiction goes against what many Christians would call free will.
Talking about and emphasizing free will in beating addictions is one thing that will improve one’s odds. It makes sense too, as people rationalize away the fact that they are using drugs, alcohol, whatever. It is hard to stop, but ultimately the person addicted must be the one to make the decision to stop. Seems obvious, but few talk about it. I think that is what this author was saying.
AA’s step 1 is “We admitted we were powerless over alcohol— that our lives had become unmanageable”. This de-emphasizes free will and is harmful.
I hope I have helped somebody who knows somebody who needs help.
Dr. Lance Dodes, thank you for sharing your experience, strength and hope.
Very catchy phrase.
Gateway drug.
I was in and out of AA for 30 years mostly not drinking by force of will (white knuckling it) and would always end up drinking again. I was seeing therapists and psychiatrists during this time also. I was constantly hauled off to the nut ward for anger issues.
It wasn't until I got a sponsor and worked the steps did things change for me. I had to get humble. I had to have a deflation of ego. I had to get honest and trust the program because nothing else worked. I just said today that my sponsor is the best therapist I ever had and meetings are the best group therapy ever. And, it's all free.
You’re blessed!
Thanks.
:) Absolutely!
Nailed it.
This guy is a tool and an idiot. The success rate for AA and Celebrate Recovery is only 5%-10% because that is the percentage of people who have reached their low and are ready to change.
Very few (fortunate) people are able to fully recognize their slide into the pit, stop themselves before hitting bottom, and claw their way back up and out. Most of the time we have to go all the way down, before we are ready to climb back out.
Our pastor quotes an old saying - “People will change when the pain to stay in their addiction becomes greater than the pain to stop”. That’s how it was for me. I brush with death and a life threatening illness woke me up. Thankfully I found Celebrate Recovery to give me the tools to walk in freedom. AA and CR are tools not a cures. Hammers are great, but they won’t drive that nail into the wall until I pick it up and start swinging.
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