I see a lot of misunderstanding in the article and in the comments here that I would like to address. I am very familiar with NA, AA's narcotics-focused sibling, having found sobriety for 15 years now. I will be saying NA, but please understand that what I say also applies to AA.
I never really understood why the twelve steps work, until I did. This is a long and rambling explanation of what I have learned.
If an actual cure for addiction was found, almost everyone in recovery would jump at the chance. The view in NA is that addiction is a disease and that there is no cure the best we can hope for is being "in recovery" as opposed to being "in active addiction".
There are three main phases to a success story in NA: the newcomer, the sponsor and the relapse. All three are necessary for long-term treatment of addiction.
The newcomer is a very emotional person often burying their emotions at the expense of those around them. Imagine the cognitive dissonance of one who loves their family members, but steals from them all-the-same. There is nobody with whom to discuss these feelings outside of NA, nobody who will understand. This leads to coping strategies which are unique but ultimately ineffectual.
Addicts typically exhibit above-average intelligence. It is very difficult to maintain a $200 per day addiction while your social skills, dependability and general appearance are quickly declining. This intelligence allows an addict to continue in life by "working around" the issues they encounter until that becomes impossible, this is what is referred to as "rock-bottom". At rock bottom the only choices are jails, institutions, death or recovery. For those lucky enough to seek recovery, NA provides a vocabulary and tool-set for correcting those the issues which have been piling up in the addicts life.
The twelve steps start off with three steps which are impossible to achieve without hitting rock-bottom. Admitting powerlessness over addiction, believing that there is a power greater than oneself which could restore sanity and making a decision to turn one's will and life over to that higher power. Once an addict is ready, these steps take very little time to complete.
The remainder of the steps walk one through the process of coming to terms with their lies, justifications, crimes and other misdeeds. Often the last 9 steps are just repeating your inner-dialog of the past few years out loud with another person, because it is hard to hide the faulty logic when there is someone actively listening.
Once an addict is able to face reality, it is important to engage the community and to start collecting responsibilities such as making the coffee before the meeting or setting up the chairs. These small responsibilities provide a way to prove oneself to the group as well as to oneself. The responsibilities allow an addict to begin rebuilding a life where they are used to being relied upon.
Once someone is able to feel good about where they are in life, it is time to move onto the next phase, sponsorship. It is easy to justify relapse once you are in a good place, after you managed to crawl out from rock-bottom. That is why sponsorship is so vital.
It is said in "the rooms" that "we keep what we have only by giving it away". To avoid relapse, we need to be aware of what is called "euphoric recall" where you only remember the good and forget the bad. To keep the memories accurate, we need to constantly talk about the problems caused by addiction and to keep from having the same conversations over and over again, newcomers are essential. sponsorship is a two-way street with the newcomer gaining an understanding support group and the sponsor being reminded of the malfeasance of addiction.
Sponsorship is also the next step in collecting responsibilities. It moves the responsibility from the group to another individual who relies on you in a life-or-death sort of way. The stakes are much higher and one is hopefully less likely to lapse on them.
The third and final stage is relapse. Relapse is a part of recovery and if we fail to recognize this, it is only that much more difficult to revisit the idea of recovery. Relapse can happen at any time and with or without reason.
In the end, the twelve steps are one way to treat addiction and it works for a lot of people. I believe that it is better if we try something which is sensible and has been shown to work. That being said the twelve steps do not claim to be a cure, but rather a rocky and dangerous road which leads back to sanity.
"Keep coming back, it works if you work it, so work it because you're worth it."
PS. The higher power I chose was NA itself, this allowed me to avoid the religious aspects while putting my faith in something more than a door-knob.
I've been sober for two years now after peaking at a liter of vodka a day. I joined AA and found the meetings themselves to be the most helpful thing to me.
I've not followed the steps as prescribed and 100% buy into the higher power being the rooms themselves. Just having a safe place to go and talk, without fear of reprisal or judgment, aided my recovery far more than any book did.
People get better in AA; people relapse in AA. Finding what works for you gives you the best chance of success, and AA, at the very least, should be part of most plans. It may not give you your moment of clarity, but just being able to talk, listen, and know you're not alone is worth five times the entry fee!
I can concur, I'm going on two months of sobriety from alcohol and stimulants tomorrow morning, only on using the 1st three steps and my employer's EAP. For now, the 1st three steps are enough to get me going plus an intense fear of where I was headed for (jails or institutions or death). I know I will have to ask for help to complete the 4th step but I still don't talk a lot at the meetings beside presenting myself when I'm asked so this will come when I'm ready or meet a suitable sponsor I guess. Maybe I will ask publicly if someone is looking for a "protégé" - is that the right word? - and would be interested to help me when I go get my 2 months' key ring on Saturday evening. I think it would avoid the awkwardness of asking to many people. Anyway, what Cliff is saying is exactly right as far as I can tell so far..
* I'm also reading Russell Brand's book on the 12 steps, it's called "Freedom from Our Addictions". It's a very good "update" for newer generations about what the 12 steps are and why you should follow them if you need to.
Thanks for sharing, I would advise you to hang around after the meetings and just get to know people after that you should ask if any commitments are available and take any that pop up. Finding a sponsor is a personal journey, and you should concentrate on finding someone who you can relate to and who you can look up to; remember it's a two-way street.
Do not rush into anything, this is a journey and the first steps are enough until they're not and when that happens you will know it and hopefully you will have become familiar enough with the regulars that the choice of sponsor will become obvious.
When I did my 5th step, I did it with my therapist. At that time, I wasn't ready for anyone (even my sponsor) to know my history. I had such a fear of doing my 5th step with my anyone who could gossip, that it really prevented me from doing a thorough 4th step. My therapist couldn't because of doctor/patient privilege and that eased my mind and with that I did a thorough 4th step.
The 5th step states "we admitted to God, to ourselves and to another human being the exact nature of our wrongs", it leaves it open and up to us as to exactly who that other human being can be.
I have an aggressively atheist friend who tried AA but was unable to deal with the religious stuff.
Thankfully, he's a really persistent guy and worked out a pattern/habit that keeps him sober, but it makes me feel bad for others who feel alienated by the religion thing but also lack the willpower to go it alone.
I suppose I'm in the "despise AA" camp. After decades of alcohol abuse, I quit drinking using Naltrexone following the "Sinclair Method". In my opinion it's a far more rational and reasonable treatment program as compared to AA's 12 step.
I would encourage anyone who wants to stop drinking and doesn't feel well served by AA to try to find a doc willing to prescribe Naltrexone and give it a try.
Unlike AA, the Sinclair method not only works but it has a well understood mechanism of how it works and emphasis self-control rather than learned helplessness. It's psychology 101 really.
What you say interests me. I am not an alcoholic but have lived in close proximity to one all my life. One of my observations is that a strong desire for self-reliance and control can prevent the person from accepting that they have a problem. In other words everything has to happen on their terms or not at all and it is partly this unwillingness to accept the common nature of their problem that makes any change impossible.
Regardless of the merits of AA specifically, it seems to me that if such a person can acquire the humility to accept help that would be the key to breaking the underlying emotional impasse. This could be characterized as "learned helplessness" or as a recognition that not everything is within our power and that external help is OK.
I guess what I'm saying is that for some alcoholics the desire for an impossible level of self-control is the source of the problem and, ironically, leads to this uncontrolled behaviour.
It's really frustrating to read healthy people criticize a method of treatment for sick people that was created by other sick people out of desperation.
Sure, and while we're at it, we should also not criticize faith healers who do parlor tricks with soggy sponges to cure people of cancer. After all those patients are desperate and spontaneous remission is a thing. So what, some of them might have had a better chance with a chemo or surgery but Land of the Free, right?
Look, as far as I'm concerned, as long as you're not hurting anyone (and that's asking a lot because addiction hurts more people than just the addict) you can seek out any nonsense therapy you want. Wave a chicken, swallow some sugar pills and pray the gay away.
But the second your ghost healing clinic becomes the industry standard and courts send people their under threat of punishment it's no longer fun and games. Those people could be helped if they received proper treatment but instead they get to waste their time (and worsen their health) by sitting through a so-called treatment that actually makes them less likely to succeed in overcoming their addiction.
But the premise of the AA falls flat if you don't accept the notion of a higher power (and many chapters of the AA are fine with substituting arbitrary objects for God for that purpose so they're acknowledging the higher power doesn't actually have to do anything).
Yes, the first step in beating any addiction is to recognise that you have an addiction and to decide that you want to get rid of it. But that's true for any other psychology problem: if someone's clinically depressed but refuses to cooperate with their therapist, they're not going to get better.
The thing is that with normal secular therapy you learn to control yourself. You learn to reflect on your thoughts and why you might have them. If you're depressed, you don't really want to kill yourself, you just think you do because you can't imagine things will ever be any different. If you're addicted, you think you need the drug because it's the only way to feel better but of course it isn't.
That said, the bigger problem is that addictions are rarely isolated problems. There's usually something that started it and something that sustains it. Frequently addiction starts out as a coping strategy (I'd say for many adults nicotine and caffeine are obvious coping strategies although they become inefficient on a chemical level fairly quickly).
I'm not seeing addicts should avoid therapy and simply will themselves out of their addiction. This works for some people but obviously not universally (again, consider how giving up nicotine is so challenging it has become a widely known trope in Western media). But those people who can't do it on their own should instead seek actual help, not the AA.
For all we know, the small group of people who actually managed to overcome their addiction while attending AA would have been able to do it on their own, whereas those who failed would have benefited from actual fact-based therapy.
You wouldn't suggest a treatment as the go-to default solution if its viability was never tested and there are easier and more reliable treatments that have a scientific basis and have been proven to work.
The great thing about the Sinclair Method is that it works both if you do it yourself or with supervision. You don't have to will yourself to stay sober, you just have to will yourself to take the pills and your body does the rest. Sure, that in itself is a feat of willpower but that's why actual therapy is a thing that exists.
In the UK Nalmefene is approved for this kind of alcohol treatment also. It's less toxic to the liver than naltrexone so GPs can prescribe it (without specialist intervention and liver checks).
Disclaimer: am shareholder in manufacturer. Feel there is a massive lack of emphasis on novel pharmaceutical interventions in drug and alcohol rehabilitation.
> In the UK Nalmefene is approved for this kind of alcohol treatment also. It's less toxic to the liver than naltrexone so GPs can prescribe it (without specialist intervention and liver checks).
Hadn't heard of nalmefene, thanks for the reference. Naltrexone is also useful in much lower doses than the standard 50mg tablets, as "low-dose naltrexone" (1-5mg).
IIUIC the Sinclair Method is very much a CBT hack. The drug disrupts the positive effects of alcohol. By making the experience of consuming alcohol unpleasant instead of rewarding, it becomes easier to overcome the psychological addiction.
Interesting - I've been thinking of trying it out but was going to use a clinic like contral.com in Finland. Maybe I'll just see if I can find a local doc who will write me a script
There's a book that outlines the treatment program. If I recall, I just found a PDF online. Basically it calls for a dose before drinking and before long it's no problem to just not drink any more.
I will say that drinking while taking Naltrexone was an odd experience because I felt none of the europhoria that typically comes with drinking.
I have never felt any kind of euphoria with alcohol; experimenting, I've reached large enough amounts to severely affect my balance, coordination and concentration, but was otherwise hardly affected at all (as confirmed by a teetotaler friend who was with me in some of those times).
Some people, when I tell them that, respond with "well, what did you expect? that's drinking" and some with "that can't be, perhaps your vodka was watered down". Your comment reminded me of that.
Having experienced both versions (euphoric and non euphoric), do you have any insight about the difference, how much of it is physiological vs. psychological?
Bill Wilson, one of the two founders of AA, was an enthusiastic proponent of using LSD to treat alcoholism. He had taken LSD himself, found it helped him, and thought it could help others.[1][2]
Needless to say, AA itself rejected this approach, and Wilson's experience with and advocacy of LSD as a promising treatment for alcoholism is not something they like to publicize.
Considering the amazing preliminary results for LSD and ketamine in treating depression and other illnesses likely related to neurotransmitter issues, I won't be surprised at all if LSD helps addicts as well.
I've been to a number of AA meetings. I can understand some of the reasons why they rejected the approach, especially those in NA abstaining from anything but OTC painkillers even after surgeries, but their systems will be challenged as medicine advances or even just society relaxing our drug fear mongering.
I fear their militant adherence to their desire to stay sober could end up with them hurting themselves similar to religious groups rejecting blood transfusions or organ donations.
That's the first thing I thought of when I saw this article. I wonder how AA would be different if they could have used this as a therapy? I wonder if it could be used in the future if it were ever rescheduled?
Anecdotal experience with a men's AA group that a friend of mind joined (and brought me along for moral support): a big part of the value that AA provides is a support network for dealing with some of the trauma and self-loathing that they had previously been using alcohol to drown out.
The degree of emotional intimacy in the relationships was something I missed when I moved to a different city and (not being alcoholic) no longer felt comfortable going to meetings.
The one thing I am noticing is that every group seems different. I have been several times however found the religious aspect very off putting. I did find being able to talk to others helpful however. If there wasn't the god bothering aspect I'd probably still go semi-frequently today having been sober for over ten years now.
To anyone like me out there, anti-theist but alcoholic, it is probably still a good idea to go to a meeting, at least once. Your group might be very different and even if you don't agree with everything it will show you that you aren't alone.
Meetings have made me very accepting of people with different views on these subjects than myself. One story I often return to is of a guy who had been so far gone, when he went to visit his mother the first time in years, she simply closed the door in his face without saying a word. If a man's path from that to healing involves Jesus, I am not going to stand in the way.
I can't remember ever having to explicitly ask for tolerance of my non-belief. We speak for ourselves, in the meetings and afterwards.
I should say that I'm not in the US, and that this might be reflective of being in a society where public displays of religiosity are, generally, less common and less accepted.
I was certainly welcomed to the meetings and at no point felt uncomfortable or was made to feel 'bad' for my non-belief. I just find when everyone talks of how Jesus helped them, and the hand holding prayer sessions an obstacle to my participation.
I believe it's possible to get sober without needing a 'higher-power'.
Interested to see the downvotes to my comment. HN is a funny place indeed!
I dated a sober person in the AA program for a number of years. They had 15+ years which I applaud.
I agree with you that one of the things I didn't like was the whole higher power cruft. They say it can be anything as long as you acknowledge that it's greater then you. I know some people who's higher power was the sun or other celestial bodies, because they were atheist and highly scientifically minded.
I'm with you, I believe it's possible to get sober without a higher power. I think I remember reading some where that while AA doesn't publish success rates, at one time they did and it's 5%, which is the same percent for cold turkey.
My logic is that to overcome your addiction you need to take control. Having a higher power is unnecessary, you have to want to do it for yourself and only you can actually achieve it. Others can help, but mentally, physically and emotionally it needs to be all your own work or it won't work.
That said, if it works for people then great! I think such an organisation is very important, it's just a shame for me I can't participate as the I disagree with the fundamental element. Ancillary stuff is great.
If there was need for it, I'd be up for helping with any online, atheist/secular AA style program. I feel some sort of duty to help others as unless you have been there, through all the shite that goes with it, it's hard to understand.
It's funny, I was raised in a restrictive religious environment and rebelled against it early on. I remember asking my dad one day why god couldn't help me clean my room, the response was, "God helps those who help them selves".
So I do the work and he gets credit? No thank you!
You're absolutely correct, it is up to you. There are external(non super natural) forces that can help, but ultimately it is the internal that has to start and sustain through change.
I'm not an alcoholic, but am very familiar with AA. The assent to a higher power thing is tough for many that I know in AA, but they still find benefit in it(AA). I tend to think that the higher power thing is useful to help externalize some of the bad things that happens in life (while still realizing that you have to deal with them). The narrative would be like, "This bad thing was put in my life by something beyond my control. It's not my fault this bad thing happened to me." I think this is useful for both historical trauma and issues those in AA deal with in the present.
I am not an alcoholic or addict in any way, but I am a practicing Christian. I can't imagine downvoting you for what you're saying. I believe it's possible to get sober in many ways. I also believe the 'higher power' is the better path, but I wouldn't disagree with your premise.
I hope the sessions were able to help you regardless.
A friend of mine considered joining his local AA group and I advised against it. The reason being he is easily led and it was inevitable that weaker members of the group (those who had no chance of quitting) would attach to him and undermine his efforts.
At his first meeting he made a friend who suggested they share a few cans afterwards. He didn't go back to AA but joined another community style self-help group and exactly the same thing happened.
Anecdotally, I have heard similar stories from people attending stop-smoking groups and even weight watchers.
So... the big factor muddying the waters for AA is that it is, in many cases a state-sanctioned option where "anonymous" behavior modification (have you checked in with your sponsor?) takes on the force of law. It's possible to have a substantial variation in your treatment by the courts as a result of whether heavily AA-associated folks around you say that you are getting with the program or whether you are still in 'denial' (it's not just a river in Egypt, fnarr fnarr). I have met people whose continued freedom as non-violators of probation or parole more or less depends on the say-so of various quasi-governmental types as to whether they are paying lip service to Bill Wilson.
I'm going to say that I'm fine with the idea that if people find the rooms work for them, great. However, the idea that a program that doesn't show any real statistical effectiveness as compared to secular programs should be adopted by the state is creepy and weird and fucked up, and no amount of bullshit dodges ("your higher power can be a cat, or a doorknob") makes this less fucked up.
I agree, I do not like the idea of mandating a twelve step program in a legal setting. It actually makes the rooms a little more hostile, but it is accepted because maybe one of the people ordered to attend might be willing and ready to take part in recovery and it would be a shame for that person to miss out.
I was ordered to attend, but luckily it was after a long time being in the rooms willingly.
My father was an alcoholic and went to meetings for over 20 years. Then, one day he felt strong enough to stop going to meetings. A few years later, he was dependant on opioids, which began as a perscription to back pain. I have my doubts he would have gone this direction had he still had the support of being "in the program".
Also, I'd say I've been to well over 100 of these meetings as a youth. I'm really happy I did, as it led me to see how some of the most beautiful people lost everything due to their substance abuse issues, which in turn led me to lead a clean life.
Look. The posts talking from experience about naltrexone and therapy are good...But let's not mislead people.
AA has been incredibly successful over the years. Yes, it needs to be done in conjunction with therapy. Yes, psycho-pharma can help in massive ways. Those are things that anyone trying to get sober should also look at.
AA doesn't work for all personality types. But it's far too fashionable for armchair scientists on the internet to shit on something that has helped more people than you can possibly imagine.
Just because you are a smart person and you get all the jokes in Rick and Morty doesn't mean that you are the all singing all dancing voice of dispassionate inquiry. There are people that need to know that help if available to them and that it works.
Your opinions on this and most other subjects are useless, but in this case it might stop someone from getting help.
If you think you have a problem, please talk to a doctor or find an AA chapter. They will help you.
>Lance Dodes, a retired psychiatry professor from Harvard Medical School, looked at Alcoholics Anonymous’s retention rates along with studies on sobriety and rates of active involvement (attending meetings regularly and working the program) among AA members. Based on these data, he put AA’s actual success rate somewhere between 5 and 8 percent. That is just a rough estimate, but it’s the most precise one I’ve been able to find.
A big reason why people criticized AA/12-steps is because it is not evidence based and, frankly, some of it teachings are factually incorrect.
And the biggest problem with AA is stated in TFA: "rigid interpretations of the 12 steps can even lead people to reject treatments or approaches that work for some people."
Expecting a treatment to be evidence based isn't being "an armchair scientist." We should absolutely demand evidence based treatment!!
AA is really just a support group/fellowship. There's nothing wrong with that, but it's not a medical treatment so let's not keep pretending it is. I think this quote from TFA is spot on: "...one of the big non-spiritual reasons that 12-step treatment and AA work for some people: They help foster changes in a person’s social network."
>In any other area of medicine, if your doctor told you that the cure for your disease involved surrendering to a “higher power,” praying to have your “defects of character” lifted, and accepting your “powerlessness,” as outlined in the original 12 steps, you’d probably seek a second opinion.
Confession time: Hi, my name is [redacted] and I'm an alcoholic who tried AA a couple times and spent a few years shitting on it after that. Looking back, most of this was due to the heavy emphasis on Christianity within the groups I attended, and I have since learned it doesn't occur in all areas.
My current approach is harm reduction, then sensible moderation-- I have gradually brought my drinking down to 3-4 drinks per day after a peak at 20 or so a while back. My ultimate goal is an average of 2 per day or less. I am not fully confident I will succeed, but continuing to try is the lifestyle change I am hanging on to. I got to this point by focusing on the things I wanted that alcohol was preventing, along with getting better exercise, nutrition and sleep.
I don't think my approach would work for everyone. It wouldn't have even worked for me a few years ago. As others have pointed out here, this is an extremely complex issue with lots of ever-changing variables.
AA is a stopgap. It is the most widely available & accessible program, available nearly everywhere, and it's free. For some people, in some groups, it is far better than nothing. For others in other groups, it may be worse than nothing. Regardless, I'm convinced it saved the life of a dear friend of mine and I cannot casually dismiss it any longer.
If you suspect you are an addict, all I can tell you is that any time you feel the tiniest spark of inclination to do something about it, chase that. Try different things until something seems to start working, then stick with it for a while. There is a good chance you'll eventually find a way out-- studies have reported varying numbers, but it appears that at least 1/3 of people in this predicament do.
The important thing is to destroy that sense of being resigned to your fate, and to value whatever you've ever loved in life enough to act. You absolutely can have a brain that works better and behaves more like you want it to, and and this affects everything you experience.
Absolutely. (And I say this as someone without a dog in th
I want to add to the above.
It may not help everyone, but it's helped a lot of people with a lot more than just stopping the addiction.
I'm not part of NA or any 12-step fellowship, but I have colleagues and close friends I deeply respect who give credit to '*A' for showing them how to make for themselves better, happier, more fulfilling lives than they could have without them.
Perhaps it's not the best system for everyone, but the core elements of meditation, self-accountability and rigorous honesty have helped my life, even as an outsider.
Kind of tangential, but I found the AA 12 traditions really interesting; these aren't about recovery, but about how the groups are organized:
1. Our common welfare should come first; personal recovery depends upon A.A. unity.
2. For our group purpose there is but one ultimate authority – a loving God as He may express Himself in our group conscience. Our leaders are but trusted servants; they do not govern.
3. The only requirement for A.A. membership is a desire to stop drinking.
4. Each group should be autonomous except in matters affecting other groups or A.A. as a whole.
5. Each group has but one primary purpose – to carry its message to the alcoholic who still suffers.
6. An A.A. group ought never endorse, finance, or lend the A.A. name to any related facility our outside enterprise, lest problems of money, property, and prestige divert us from our primary purpose.
7. Every A.A. group ought to be fully self-supporting, declining outside contributions.
8. Alcoholics Anonymous should remain forever non-professional, but our service centers may employ special workers.
9. A.A., as such, ought never be organized; but we may create service boards and committees directly responsible to those they serve.
10. Alcoholics Anonymous has no opinion on outside issues; hence the A.A. name ought never be drawn into public controversy.
11. Our public relations policy is based on attraction rather than promotion; we need always maintain personal anonymity at the level of press, radio, and films.
12. Anonymity is the spiritual foundation of all our traditions, ever reminding us to place principles before personalities.
Specifically I find it interesting how the anonymity really comes out not in how people relate to each other, but in how the group relates to the world: there are no formal leaders, entanglements are avoided, professionalization is avoided, and the rules keep the concept of AA from being confused with any individual. The traditions feel like a kind of governance to avoid governance.
I really like the traditions. I think they are a very good foundation for keeping small groups of people cooperating and I wish they were emphasized more outside of recovery programs.
I have not had a drink for 33 years. I know a fair amount about AA. One fact is that one of the principles of AA is to maintain anonymity at the level of "press, radio and film" This principle has been stretched quite a bit in recent years, but if I was a member, I would not state it in print.
I think one of the best description of how/why AA works is by Charlie Munger (Warren Buffet's Partner) in his book "Poor Charlie's Almanack"
He describes the various mental models that we humans use, and talks about how AA uses the "Lollapalooza Effect" to help alcoholics beat their addiction.
One big issue with AA, as brought out in the article here, is that there is no official AA regulatory branch. In any given cluster there is self policing, but a new person must be aware that this society is a great place for Con artists to hide out also. I know many people who have stopped drinking and gone on to great lives. I also have a great collection of stories about crazy people and cons I have met along the way.
TLDR summary: AA really works, but especially at the beginning- be careful.
Anecdata aside, it seems like almost no one here has read the article. It talks about research, the scathing Atlantic article, and medication.
My take is this: AA works for some people. That doesn't mean it should be "prescribed". It varies from meeting to meeting, it's shame-based text (Big Book) might cause harm, and secular support groups seem likely to work as well or better.
No one is saying AA didn't work for you. That's just a totally different argument than "AA should be society's first (and sometimes only) treatment for the disease known as alcohol addiction."
I wish there was something like AA (or any effective treatment) for Internet addiction. Its special feature is that you can't realistically quit the Internet entirely, especially when you have a profession that relies on constant Internet access.
I would suggest going to a few AA meetings and just sitting in the back. You might be surprised what you pick up just by being a 'fly on the wall'.
Also: Not all meetings are the same. I would suggest finding one that uses the Big Book of AA, doesn't allow cross-talk (they shouldn't be trying to solve each others problems), and seems 'healthy'.
You could probably talk to a psychiatrist and get a CBT program going and maybe get them to prescribe naltrexone or something (maybe in a clinical trial). Some people downgrade their technologies to get away (e.g. dumb phone etc..)
If it is a problem outside of work then you can take steps to minimize your access to the Internet outside of work hours and then during work have some filters set up.
My father was in AA, and I'm reasonably sure it saved his life, or at least lengthened it substantially. It was a major factor in getting him out of a spiral of depression and business failure.
For him, it put him in touch with a community that understood his depression (in a way that I, in particular, never did), and helped him work through that. Stopping drinking was ultimately almost incidental -- it was the initial goal, obviously, but that was only the beginning.
He also said he saw a lot of people come in to the program because they felt like they needed to tick a box labelled "recovery". Some of them had been sent by the courts as a condition of getting visitation rights for their children, or by well-meaning marriage counselors, or to prove to themselves or others that recovery was impossible. Very few of those people stopped drinking and changed their lives. If ticking the box was their goal, then arguably it's a success by that metric, but by the program's own goals, of course it wasn't.
From his point of view, AA is a tool, if you want to change your life, you can use the AA steps and community to do it,
and your odds are fair, although of course there are no guarantees ever.
What is consistently missing in the conversation about addiction is Alan Carr's book "The Easy Way to Stop Drinking" and "The Easy Way to Stop Smoking"
reddit/r/stopdrinking is also an invaluable resource.
My experience is that people that really get into AA and find it useful have translated one addiction, to alcohol, into another, AA meetings. People that go to a meeting, or more than one, every single day, and get twitchy if they don't get their fix. I suppose that's healthier than getting blotto all the time, but it's not something most people can tolerate, and is difficult to sustain.
It wouldn't be so bad if it was a program solely for people that needed that kind of overriding presence in their life, but AA is also swollen with people that are forced into it because they've fucked up and are court-mandated to attend for X weeks because they made a poor decision and got pinched for a DUI or other alcohol-related brush with the legal system. For those people, it's something they need to endure, and get to the other side of, so that they can get on with their life, and the AA model of perpetual recovery and rhetoric about "dry drunks" if they don't buy in is actively harmful.
Yeah, I have a family member who gets his kids for the weekend and instead of interacting with them he leaves them in his house in front of the TV while he drives from AA meeting to AA meeting. All weekend! And he hasn't even drunk alcohol in like 20 years.
The brain is complex. Addiction is complicated. It's just not reasonable - based on our current knowledge of both - to expect every treatment to work everytime for every person.
Perhaps some day we'll figure out how to get the brain to completely unlearn addition. We're not there yet. That doesn't mean we shouldn't try.
addition is an interesting typo because essentially whats going on is brainwashing for the purpose of eliminating an addiction, and we have massive brainwashing infrastructure around substituting many phrases in the place of "addiction" although addition would not have been the first choice LOL.
We have enormous budgets trying to brainwash us to buy laundry detergents and cars and vote for politicians but as we know from extensive work in those fields that the individual susceptibility to brainwashing varies quite a bit by individual, demographic, culture, etc. It would not be a excessive extension to propose that anti-addiction brainwashing is likewise highly unpredictable.
The good side of alcoholism being uncurable is if we found a brainwashing method to perfectly eliminate it, the technique or pill or meme or whatever would be abused for consumerism and political purposes into an amazing dystopia. Admittedly a sober alcoholism free dystopia, but a horrific dystopia none the less.
Anecdotal, but from my own experiences with recovering (and not recovering) addicts in my family, the AA/NA approach seems to only redirect addiction away from the drugs or alcohol outlet, instead of "curing the disease" of addiction itself.
All the recovering addicts I know are still addicted to something in one way or another. The new addiction may or may not be a healthy one. For instance, running 100+ miles a week, every week - while objectively better than drinking yourself out of a job and home - isn't exactly "healthy".
I also notice a higher level of selfish behavior among the recovering addicts I know. It takes an insane amount of pathological selfishness to neglect your responsibilities, especially children, for the bottle. AA doesn't seem to address the selfishness as much as just to get folks to stop drinking.
All of this is preferable to having a raging drug or alcohol addict in the family, but it's far from a perfect solution IMHO.
> All the recovering addicts I know are still addicted to something in one way or another. The new addiction may or may not be a healthy one. For instance, running 100+ miles a week, every week - while objectively better than drinking yourself out of a job and home - isn't exactly "healthy".
So very, _very_ frequently, addiction isn't "the" problem, it's a symptom of one. The behaviors you mentioned are in the same vein, something used as a way to work around whatever the problem may be. In my case, the relief I experienced from alcohol blocking out an underlying anxiety problem I didn't understand I had (and made me not care about the ADHD problem I knew I did have), it was like a miracle. The inability to speak to others, rationally work through life's tough issues, heck even my grades went UP... everything got better. And for a good 16 years it kept on being that miracle to me, going so far as to hide the worsening social, emotional, and mental calamities it was causing.
> I also notice a higher level of selfish behavior among the recovering addicts I know. It takes an insane amount of pathological selfishness to neglect your responsibilities, especially children, for the bottle.
Funny thing about this... I've come to believe that most folks who haven't experienced addiction just can't initially grasp the fact that (assuming an underlying psychological/emotional issue), the addict doesn't see the addiction as selfish, even when it disrupts everything else in their lives. There's this inexplicable compartmentalization that occurs when self-medicating via addiction, sort of like, "They don't understand how this helps me!". Which, in a way is true; they don't. But neither does the addict. Most folks who are on their way down to the rock-bottom don't understand that the activity or substance is a (terrible, and temporary) way to deal with a larger problem they either don't know they have or don't know how to properly address. All they know is that it works. Even when their destructive behavior completely isolates them, leaving them feeling alone and hopeless because it feels like everyone is against helping you to feel better, it still feels like it works.
> AA doesn't seem to address the selfishness as much as just to get folks to stop drinking.
AA, in its own way, does its level best to address this given the understanding of psychology/psychiatry at the time the Big Book was written. And to be fair, if everyone actually mustered up enough strength and humility to get past Step 5 (heh, myself included), this might be less of a concern. But from a 30k foot view, it IS a good framework to approach lasting recovery, and you replace "selfishness" with "underlying psychological problem causing the addiction" in your observation, it's probably a bit more of a clearer picture. For me, and for the vast majority of the wonderful people I lived with during my 6 months in a sober living facility, meetings were only going to be as effective as long as I was being monitored. Some folks (like myself) even found that attending meetings and hearing stories about drinking was a trigger, and although I appreciated the friendships, it was counterproductive.
What ultimately and completely removed my desire to self-medicate with whatever was on hand was CBT. The meetings were absolutely necessary for the initial support I needed to stop the destructive behavior, but CBT gave me the tools I truly needed to understand why I felt the way I did, and how to handle the thoughts and emotions that seemed to come from nowhere all my life. Although I am a believer (and give Him the credit for all I am today!), CBT has the benefit of not requiring anything other than walking the difficult path through your own screwiness. Once you've acquired the tools to handle your own brain, attending meetings may not even be necessary in order to maintain lasting sobriety. As always, YMMV, CBT is powerful enough that I'm of the mind non-addicts oughta do it too. Heck, the world would probably be less messed-up place.
Today, I'm ok with not tracking my time spent sober or keeping a heavy constant focus on what was a symptom of my problems. I'm screwed up in all kinds of clinically fascinating ways, but now I deal with it sans substances.
Despite it or love it... all I know is that the fellowships and programs of both AA and NA saved my life, so they worked for me. Thank you Bill and Jimmy and the countless others that came after you.
Does that mean it will work for you??? Who knows? Thing is, what do you have to lose by giving it a try? If it doesn't work, we can always refund your misery (that's an AA joke, lighten up, rule 62).
In all seriousness, whatever treatments or programs you follow which help you overcome your addiction, ( whether its AA, NA, CA, HA, a different A, church, signage, template, rehab, treatment center including Malibu Recovery ) doesn't matter as long as you get better. And don't let anyone ( including me!!! ) tell you different!!!!
"In some cases, rigid interpretations of the 12 steps can even lead people to reject treatments or approaches that work for some people."
There's a huge for-profit, unregulated "rehab industry" in the US that charges insane amounts of money for all sorts of unproven "treatment." There's harm in getting fleeced to line someone else's pockets.
It is not possible to get these numbers. Each group is autonomous. Of the many groups I am familiar with none has ever tracked this type of information (over the last 30 some years). If you had 20 or so very dedicated researchers who wanted to attend the meetings of 20 different groups once a week for 5 years,it might be possible to get some good numbers.
tldr: Most people who respond to surveys asking about the efficacy of the program are sober and skew the results, the anonymity of people in programs makes it difficult to identify who are potential candidates for study/surveys for external researchers, and no central authority monitoring programs so little standardisation between them meaning some groups may be more effective than others (this is somewhat reflected in a comment above about trying other groups which may mean that the real effectiveness comes from the community it brings, not the program itself, but that's pure speculation on my part)
No. That number was drawn from an internal report on triennial membership surveys[1] made for a meeting briefing for the board of trustees, and is based entirely on the inability to read a chart (specifically, figure C-1 on page 12). I'll admit, it's a bad chart, and of a poor type for the data it represents. The misreading sparked a "back to basics" movement in AA because it didn't jive with Bill Wilson's off-the-cuff estimate that about half of the people who gave it a really good go (and who weren't psychotic) would recover on their first go, and half of the initial failures would make it on a subsequent attempt. That, of course, raises significant questions around just what, exactly, would constitute giving it a really good go, and how, exactly, was the "psychotic" diagnosis of failures arrived at.
The actual number was closer to 21%... but that only refers to the number of people in their first year of membership who were still members at the completion of 12 months. The problem is that the chart lists membership percentages per month (as a percentage of all members with less than 12 months) using a sort of fever graph with a distinct line for each of the years being compared. That led some people to believe that it was a continuous line following a cohort through their first year. That's impossible, since by that interpretation there are a large number of people in 1986 (for instance) who failed to remain sober for six months but somehow made it to seven. The lines don't start at 100% and work down; there is no indication at all of how many people dropped in and never came back, etc. And do keep in mind that nobody was actually compelled to complete the survey. All it can tell you is that about five percent of the people who have 12 months or less of sobriety in AA during the survey period(s) and who were included in the survey have twelve months.
They used to publish the effectiveness but quit in the early 80's.
It's easy to track anonymous users when the same anonymous users show up for the same meetings for years. AA has had a LOT of meetings over the years, so coming up with a baseline of effectiveness isn't a vexing problem.
Why they quit publishing those numbers isn't exactly a mystery, either.
One guy sees X% of the population is a member of faith group A, and X% is a member of faith group B, where A and B are incompatible, therefore the guy is depressed that somehow proves no religion has the one true answer and all are false insert peak nihilism here.
Another guy sees the same data and is elated that the solution set of "happy successful peacefully coexisting religious people" is such a large number provably at least two times X percent.
Which outlook resonates better, depends mostly on your personal model of how you want the world to work, rather than what actually works.
This treatment devised by sick people for sick people out of desperation doesn't make much sense to me as a healthy person. It doesn't feel very science-y when I think about it.
And a lot of you are quoting Pen and Teller. Good work, you can watch TV. Thanks for you input.
Some of us “healthy” people have seen our parents, siblings, spouses, and/or friends go into programs like AA and NA and come out no better or even worse off than before.
I think the issue is that we don't really know how well it works. No one is denying that many people are helped by it, but studies as to how effective it is are lacking rigor, and AA itself is secretive about success/failure numbers, so it's hard to judge. There's enough evidence that it doesn't help a lot of people for it to make sense to want to quantify its effects and see if we can do better. And that's a problem when AA and 12-step programs are the only option for many people in many areas, and when courts can order people into these programs when they may not be the best path for the individual's particular case.
Those that swear by it are those that defeated their alcohol reliance while in AA or replaced their alcohol reliance with a reliance on AA events.
Those that despise it are either aware that AA is a placebo at best and a distraction at worst or they loathe it because it is so heavily established as "that thing you do to manage alcohol problems" that courts can send you there (even if you're not an addict and the reason you ended up in court was poor judgment, e.g. DUI).
> Those that swear by it are those that defeated their alcohol reliance while in AA or replaced their alcohol reliance with a reliance on AA events.
It’s anecdotal but in my case I replaced a reliance on alcohol by a reliance on sports. It’s likely a lot healthier than drinking but it’s a reliance/addiction all the same. I went to a few AA meetings and it didn’t work so well for me, always seemed to be a lot of guilt and shame floating around the room, though this could have just been my local meeting, too. In the end, it works for some people and that’s great. It didn’t work for me but I found another way, and that’s great, too.
The only problem with saying "it works for some people and that's great" is that it is known that sending people to AA performs worse than just leaving people to their own devices.
If you get the flu it takes about two to three weeks to recover from it naturally. Imagine there's a flu cure that extends that to two to six weeks. Sure, some people take the cure and get better in two weeks while some who don't may only get better after three weeks. But it's still blindingly obvious that you'd be better off avoiding it and those that got better after two weeks would have likely recovered as quickly on their own (or using a different cure).
Some AA advocates argue AA has a higher success rate than widely reported but the problem is that AA is extremely secretive about the actual numbers and sees recovery as a lifestyle rather than a process. AA doesn't aim to cure alcoholism, it just aims to keep people sober.
Some people simply are more prone to addiction. Teaching these people to cope by channeling that addiction into something healthier than drugs (or gambling or whatever) is great but that's not really what AA aims to do.
I see a lot of misunderstanding in the article and in the comments here that I would like to address. I am very familiar with NA, AA's narcotics-focused sibling, having found sobriety for 15 years now. I will be saying NA, but please understand that what I say also applies to AA.
I never really understood why the twelve steps work, until I did. This is a long and rambling explanation of what I have learned.
If an actual cure for addiction was found, almost everyone in recovery would jump at the chance. The view in NA is that addiction is a disease and that there is no cure the best we can hope for is being "in recovery" as opposed to being "in active addiction".
There are three main phases to a success story in NA: the newcomer, the sponsor and the relapse. All three are necessary for long-term treatment of addiction.
The newcomer is a very emotional person often burying their emotions at the expense of those around them. Imagine the cognitive dissonance of one who loves their family members, but steals from them all-the-same. There is nobody with whom to discuss these feelings outside of NA, nobody who will understand. This leads to coping strategies which are unique but ultimately ineffectual.
Addicts typically exhibit above-average intelligence. It is very difficult to maintain a $200 per day addiction while your social skills, dependability and general appearance are quickly declining. This intelligence allows an addict to continue in life by "working around" the issues they encounter until that becomes impossible, this is what is referred to as "rock-bottom". At rock bottom the only choices are jails, institutions, death or recovery. For those lucky enough to seek recovery, NA provides a vocabulary and tool-set for correcting those the issues which have been piling up in the addicts life.
The twelve steps start off with three steps which are impossible to achieve without hitting rock-bottom. Admitting powerlessness over addiction, believing that there is a power greater than oneself which could restore sanity and making a decision to turn one's will and life over to that higher power. Once an addict is ready, these steps take very little time to complete.
The remainder of the steps walk one through the process of coming to terms with their lies, justifications, crimes and other misdeeds. Often the last 9 steps are just repeating your inner-dialog of the past few years out loud with another person, because it is hard to hide the faulty logic when there is someone actively listening.
Once an addict is able to face reality, it is important to engage the community and to start collecting responsibilities such as making the coffee before the meeting or setting up the chairs. These small responsibilities provide a way to prove oneself to the group as well as to oneself. The responsibilities allow an addict to begin rebuilding a life where they are used to being relied upon.
Once someone is able to feel good about where they are in life, it is time to move onto the next phase, sponsorship. It is easy to justify relapse once you are in a good place, after you managed to crawl out from rock-bottom. That is why sponsorship is so vital.
It is said in "the rooms" that "we keep what we have only by giving it away". To avoid relapse, we need to be aware of what is called "euphoric recall" where you only remember the good and forget the bad. To keep the memories accurate, we need to constantly talk about the problems caused by addiction and to keep from having the same conversations over and over again, newcomers are essential. sponsorship is a two-way street with the newcomer gaining an understanding support group and the sponsor being reminded of the malfeasance of addiction.
Sponsorship is also the next step in collecting responsibilities. It moves the responsibility from the group to another individual who relies on you in a life-or-death sort of way. The stakes are much higher and one is hopefully less likely to lapse on them.
The third and final stage is relapse. Relapse is a part of recovery and if we fail to recognize this, it is only that much more difficult to revisit the idea of recovery. Relapse can happen at any time and with or without reason.
In the end, the twelve steps are one way to treat addiction and it works for a lot of people. I believe that it is better if we try something which is sensible and has been shown to work. That being said the twelve steps do not claim to be a cure, but rather a rocky and dangerous road which leads back to sanity.
"Keep coming back, it works if you work it, so work it because you're worth it."
PS. The higher power I chose was NA itself, this allowed me to avoid the religious aspects while putting my faith in something more than a door-knob.