Psychiatrist Dr. Lance Dodes, while promoting a book and program he's developed as an alternative to Alcoholics Anonymous, has been denegrading 12 step programs unfairly. Sure, he's entitiled to his opinion, and to advertise his undoubtedly quite costly alternative treatment for addiction. And certainly, AA doesn't work for everyone. But Dr. Dodes' criticisms, widely circulated now among the learned folk of National Public Radio, deserve a rebuttal, because, as both a psychotherapist and person in recovery myself, I experience AA and the 12 step world as such a useful and accessible resource, replete with such wisdom of the ages that I often feel it informs the helpfulness of my practice as much as and sometimes more than has my professional training. And, especially since AA meetings are so many and so available for no cost whatsoever (save for a requested voluntary donation of a dollar or two from those who can spare it), I hate to think of people in need being put off from being embraced by the care available in AA's rooms by Dodes' arguments.
For example, Dr. Dodes claims that AA sees relapses as failures and asks for the return of its celebratory chips commemorating recovery time (30 days, one year, etc.) when relapses occur. He said on All things Considered that, in his view, to have gone six months without drinking, even if one has a beer at the end of said time, is applaudable and certainly a better course of action than having had a beer every day during those six months. Well, not only is everything that happens in AA voluntary, including who gets a chip and for what, and never, in my near 30 years of involvement have I seen a chip returned or anyone asked to do so, but, if AA members express concern about relapse, it's because, in our collective experience, rarely, dare I say never, have we seen anyone have that one beer every six months and go on to incorporate into a happy, balanced, normal life such a manner of drinking. For an alcoholic or addict, one drink typically leads to another, and just as typically leads back into a life of active and destructive use and abuse. It most often begins a slide back into the depths from which most of us in AA don't want to return. It happened to me once, after 6 years of sobriety and not enough traction in the AA program, that I tried having a single glass of wine at a dinner with a cousin who was visiting from out of town and who I did not want to know I was self-defining as alcoholic. I can hardly imagine now why I cared. It took some months before I didn't refuse a neighbor pouring me a holiday drink into a silver goblet and a few more before I poured myself a glass to have with a sandwich at lunch by myself. Before long I was both drinking and smoking pot daily, using pain pills (instead of the more effective swimming and yoga) for my back problems, and getting beta blockers prescribed for for those difficult moments of professional test taking and public speaking. And it didn't take long before before the trials of daily life became my tests, and socializing at parties a form of public speaking. The fact is, as the majority of us who attend AA meetings can attest--and good/lucky for you if this doesn't apply--we can't have a single beer without disasterous -in the long term --results.
Dr. Dodes is correct when he says that statistics proving AA success are not available. That's precisely because AA is an association of the anonymous and is not professionally led or affilliated. Still, the sheer volume of AA meetings worldwide and the large regular attendance at so many of them, says something important about AA effectiveness and popularity. Of course, AA is not effective for everyone. The "God" thing has kept many away. I did me for a long time. Of course, AA makes clear that God can be defined however one feels comfortable doing so, and there is an active and growing segment of AA for Agnostics and Freethinkers of which I am a enthusiastic participant and supporter. The first international Agnostic and Freethinker convention is set to take place in Santa Monica this coming November (2014).
In another criticism, Dr. Dodes complains that AA unjustifiably blames the alcoholic when its program doesn't work for someone. And while my experience is that compassion is far more prevalent in AA than is blame, we do come to be wary when someone stops going to meetings, or stops meeting with or being a sponsor, or stops in whatever individualized way s/he has been working the 12 steps, because, this is often the beginning of a slide back into active addiction. Similarly, any health practitioner would be concerned if a patient stopped taking prescribed medications, or went off a recommended diet or refused the physical therapy that was needed for a specific condition. That concern, too, could be called blaming the patient for his or her return to active disease, but there is only so much a practitioner, or a program can do without the active involvement of the person using it. How many doctor's would say to a treatment refusing patient, "perhaps you should seek out another doctor who might not suggest the things I have promoted as integral to your health and well-being." Besides, being non professional and anonymous, there really isn't anyone in AA to give that kind of advice. Therapists and rehab counselors do that. I do that. I have seem lots of clients who I hoped could/would benefit from AA, but when some won't or can't deal with their addictions that way, I recommend other ways, never losing hope that they might find their way back in to the rooms where, in my anecdotal experience, the most effective results take place.
The late humorist George Carlin often joked that the best answer to the problem of substance abuse would be a better reality. And while alcoholism, being a condition of both genetic and social origins is not necessarily created by adverse life circumstances, it strikes me that a lot of what is so useful about AA is that it does change reality for its members. Where once most alcoholics felt isolated, in AA they/we have supportive accepting and compassionatecommunity, where many felt morally bankrupt, in AA they/we find purpose and an ethical compass. And this is something no new program, developed by an individual fee-charging doctor can offer.
For example, Dr. Dodes claims that AA sees relapses as failures and asks for the return of its celebratory chips commemorating recovery time (30 days, one year, etc.) when relapses occur. He said on All things Considered that, in his view, to have gone six months without drinking, even if one has a beer at the end of said time, is applaudable and certainly a better course of action than having had a beer every day during those six months. Well, not only is everything that happens in AA voluntary, including who gets a chip and for what, and never, in my near 30 years of involvement have I seen a chip returned or anyone asked to do so, but, if AA members express concern about relapse, it's because, in our collective experience, rarely, dare I say never, have we seen anyone have that one beer every six months and go on to incorporate into a happy, balanced, normal life such a manner of drinking. For an alcoholic or addict, one drink typically leads to another, and just as typically leads back into a life of active and destructive use and abuse. It most often begins a slide back into the depths from which most of us in AA don't want to return. It happened to me once, after 6 years of sobriety and not enough traction in the AA program, that I tried having a single glass of wine at a dinner with a cousin who was visiting from out of town and who I did not want to know I was self-defining as alcoholic. I can hardly imagine now why I cared. It took some months before I didn't refuse a neighbor pouring me a holiday drink into a silver goblet and a few more before I poured myself a glass to have with a sandwich at lunch by myself. Before long I was both drinking and smoking pot daily, using pain pills (instead of the more effective swimming and yoga) for my back problems, and getting beta blockers prescribed for for those difficult moments of professional test taking and public speaking. And it didn't take long before before the trials of daily life became my tests, and socializing at parties a form of public speaking. The fact is, as the majority of us who attend AA meetings can attest--and good/lucky for you if this doesn't apply--we can't have a single beer without disasterous -in the long term --results.
Dr. Dodes is correct when he says that statistics proving AA success are not available. That's precisely because AA is an association of the anonymous and is not professionally led or affilliated. Still, the sheer volume of AA meetings worldwide and the large regular attendance at so many of them, says something important about AA effectiveness and popularity. Of course, AA is not effective for everyone. The "God" thing has kept many away. I did me for a long time. Of course, AA makes clear that God can be defined however one feels comfortable doing so, and there is an active and growing segment of AA for Agnostics and Freethinkers of which I am a enthusiastic participant and supporter. The first international Agnostic and Freethinker convention is set to take place in Santa Monica this coming November (2014).
In another criticism, Dr. Dodes complains that AA unjustifiably blames the alcoholic when its program doesn't work for someone. And while my experience is that compassion is far more prevalent in AA than is blame, we do come to be wary when someone stops going to meetings, or stops meeting with or being a sponsor, or stops in whatever individualized way s/he has been working the 12 steps, because, this is often the beginning of a slide back into active addiction. Similarly, any health practitioner would be concerned if a patient stopped taking prescribed medications, or went off a recommended diet or refused the physical therapy that was needed for a specific condition. That concern, too, could be called blaming the patient for his or her return to active disease, but there is only so much a practitioner, or a program can do without the active involvement of the person using it. How many doctor's would say to a treatment refusing patient, "perhaps you should seek out another doctor who might not suggest the things I have promoted as integral to your health and well-being." Besides, being non professional and anonymous, there really isn't anyone in AA to give that kind of advice. Therapists and rehab counselors do that. I do that. I have seem lots of clients who I hoped could/would benefit from AA, but when some won't or can't deal with their addictions that way, I recommend other ways, never losing hope that they might find their way back in to the rooms where, in my anecdotal experience, the most effective results take place.
The late humorist George Carlin often joked that the best answer to the problem of substance abuse would be a better reality. And while alcoholism, being a condition of both genetic and social origins is not necessarily created by adverse life circumstances, it strikes me that a lot of what is so useful about AA is that it does change reality for its members. Where once most alcoholics felt isolated, in AA they/we have supportive accepting and compassionatecommunity, where many felt morally bankrupt, in AA they/we find purpose and an ethical compass. And this is something no new program, developed by an individual fee-charging doctor can offer.
