The Diane Rehm Show

kevincody, I have to concur that AA just turns off some folks with their approach. Particularly the powerlessness. In a way, what ever group approach speaks to one, that is an inroad into feeling comfortable in the first lace. Many of the groups out there may be leading in similar directions, but if you cant attract and keep someone interested initially, no group will work. And, much though many AA'ers say, it's not necessarily because the addict is in denial. I am sadly all too familiar with dyed in the wool AAs who disdain not just any medication support, but even the very idea of therapy. On the other had I have had some good results by actually working with an individual client's sponsor ad bringing everyone into the picture. Good for Smart Recovery and other legit self help groups.

I may not use the exact word that corresponds to your thought. That would not be unusual. I agree on efficacy, and the fact that generally recovery statistics are depressing at best.

My own approach to the spiritual element of recovery, where appropriate, is to follow the client, not to impose anything. And it's not Christianity, traditional or not, in part because where I worked in the Bible belt, that's the only notion of spirituality that folks around here commonly relate to; I don't. Of course, there are those cases of individuals switching from chemical to Bible addiction and stay sober. For them, who's to say.

I've run a relapse prevention group, nominally related to the Gorski model (loosely, really more my own creation) for 15 straight years. That's where I saw a lot of motivation. It's an uphill battle, for a disease that triggers moral depravity and punishment in people's minds.

I am approaching four years sober in AA. Having knowledge in my head does not keep me sober. Constant action does, and AA provides such a place for action.

While the steps may have been influenced by Christian doctrine, the actions in its steps can be found to be influenced by both Eastern and Western SPIRITUAL ideas.

In my area, it is discouraged to discuss SPECIFIC definitions of a higher power. I live in a mostly Catholic area. We get a lot of new people constantly talking about their view on a higher power. Yet, those with longer lengths of sobriety and who work a good program rarely mention their own views -- and don't push it on newcomers. I have only ever been encouraged not to view myself as a higher power. Other than that, I have gravitated toward Eastern practices while having no set religious dogma. This is what working a true 12-step program can accomplish. It has allowed me to seek something other than drugs and alcohol to a solution to my problem, and never suggested I joined a church or become a monk--or ANYTHING religious.

AA does not have a monopoly on recovery. Yet its existence, popularity, and success rate with those who actually wish to stay sober, allow for rehabs and books like this to exist. Yet, if something works for you, run with it. But simply reading literature did very little for me. Being willing to consider the God idea (my own conception, which is not Christian in nature at all), taking an inventory, being willing to ask for help in becoming a better person, fellowshipping with others in a similiar situation, service, and helping other people has.

By the way, I was given, free of charge, my first AA Big Book. We tend to give them away to newcomers. And they can be purchased at cost at any meeting. Donating to the meeting to pay for rent / coffee / etc is optional. You can get sober, if you want to be sober, without paying a dime. I believe this says something specific about the program.

I agree with Howlandwoof with regards to AA. Thank you for sharing your honesty, openness and willingness!

I think many people would be shocked to discover that AA is a faith-healing program that contains only myths, and no actual facts about alcohol addiction. AA claims to be “spiritual, not religious” but every higher court where it’s been challenged has deemed AA to be religious (not spiritual) in nature. It’s actually a pseudo-Christian religion. It uses the word “God” but your higher power can be a doorknob, or a bedpan, or your G-O-D can be a Group Of Drunks (meaning AA itself). That’s just plain blasphemy in Christianity. However, whatever name you give your god, it must be willing to do certain specific things, like hearing your confessions and communicating its will for you and removing your compulsion to drink, but only through a daily reprieve which is contingent upon your “spiritual” condition. It also has to be able to remove your defects of character and other various miracles.

And for those who are going to accuse me of now knowing anything about AA, yes I spent a long time in the program and I do know what I’m talking about.

I know what has worked for me and others as far as reducing or giving up alcohol, Kathleen. I don't buy into the government's campaign of propaganda against a plant, either.

I do thank you for your concern.

Also, AA is its own little bubble of information. People are taught that they must never ever question the doctrines of AA (lest they drink and die) and that they must never look outside of the program for their answers about alcohol addiction. Only AA conference approved literature can be brought to AA meetings. Therefore, they just don’t know many of the facts that are being discovered by researchers in the field. Such facts like that a survey of over 40,000 people found that 75% of those who successfully overcome alcohol dependence, do so on their own.

http://www.spectrum.niaaa.nih.gov/features/alcoholism.aspx

And that AA is largely ineffective, “helping” only about 5% of those who ever go there.

http://orange-papers.org/orange-effectiveness.html

And that the 12 step approach, either in AA or rehab is at the bottom of the list of things that work.

http://www.behaviortherapy.com/whatworks.htm

And that 12 step rehabs don’t work and are often detrimental and worse than no treatment at all.

http://www.washingtonpost.com/wp-dyn/content/article/2010/08/06/AR201008...

Hopefully rehabs will eventually be held to some higher standards and will eventually adopt evidence-based modalities. But until then, people will just continue to cycle in and out of rehab and 12 step programs. And they will continue to be blamed because faith healing just didn't work for them.

Really appreciated this segment.
I sympathized with the gentleman who explained frustration over lack of resources/dialogue/support, Before one hits 'rock-bottom'.

Luckily, we live in a technological age, that allows many to get unconventional treatment or support via the world-wide-web.

Unfortunately, not everyone has access to the internet (either at all, or 24/7...like those who can afford it, or live near access).

Without a doubt, there are those whose 'functional' alcoholism, or trending abuse of the substance, is a grave concern for them. Many of these are in high-profile jobs, whose reputation would take a real hit, if associated with having a problem.
Others live in such small rural areas with limited resources, or haven't the resources, themselves, to travel outside where they live and work, to get the help.

In part, it is shows like yours, Ms. Rehm, which continues the dialogue about addiction, that make perhaps the biggest difference of all, in overcoming these hurdles.
Thank you.

And congratulations, too, on Access Award!

With all due respect, some of the "worst rehabs" are very emotionally (and sometimes physically) damaging to patients. Many still use now discredited confrontational tactics that can be very abusive and cause lasting trauma to the patients/clients involved. I might add that some offer only one modality of treatment (many 12 step ONLY), and if that isn't appropriate to the patient they are not only back at square one but blamed for not "getting the program". I do agree that there should be treatment for all seeking help, but having sought actual medical help and been stonewalled every time, I found that the only person who could help me was myself. Luckily that worked, for all too many it does not.

part 2 of 2 part comment:

Myself,I am not fully in one particular treatment modality and, I suspect, most practitioners who have done it for a long time find their own integrated approach. For example, the so-called 'bio-psycho-social' model, and others, come across to me as a bit facile. And while I'm open to learning from any approach I find such canned approaches as a bit self promoting.

Actually, along with the idea of intervention at any stage, there has been a rise in the notion of 'dual diagnosis', which essentially amounts to looking at the individual holistically, versus the earlier, fairly strict, notion that absolute abstinence, and a good deal of time (maybe years) of sobriety must be in place before 'core issues' are addressed. This is a change from the days of separate SA and MH tracks, when MH professionals didn't want to handle SA clients and by the way didn't get trained in SA treatment, and routinely did not identify SA diagnoses issues. (some of this was related to professional rivalry, and issues of credentialing; counselors with SA specialty considered lesser) And, to a degree, it worked the other way with SA professionals who were, however, usually trained to id MH issues and 'refer out'. And docs have come a long way too, although finding a doc who really wants to work collaboratively as part of a treatment team is like finding a jewel.

Persephone, glad things seem to have worked out for you.

Thank you, Don S. I had gotten a history from not only the writings of William White and in Ms. Fletcher's book on the origins of the theories behind that model of treatment for addiction/alcoholism, but what shocks me is how in play it still is. In fact, one response I got recently was a shocked query of when my treatment took place, to which I keep saying 2010!!! And not only that, but I keep tabs on the chain I was "treated" in, and these practices are still done daily there. They also seem to think that some need to "hit a lower bottom", that they're not there yet, and encourage families in making this happen. A dangerous way to get a repeat customer, and completely out of line with what you are saying. Help at any stage is possible, and preferable.

Some times, as well, the "defenses" are simply the way humans respond to being confronted, as many studies cited by White & Miller point out, and to have someone demand of you that you tell the truth and that you are lying if you're not, well, the natural response is going to be an angrier assertion that you are not at all lying!

I agree, and in some cases doctors who prescribe addictive drugs simply need to take charge and not play pass the patient. Many would not end up addicted if not trying to stave off withdrawals after iatrogenic dependence, but no matter how one ends up there, they should be treated with dignity once they are seeking help--especially at the prices some of these places charge. But whether expensive or free (state funded or charity), addicted people should be treated like what they are: human beings.

Thank you, Don S.