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   SATURDAY, APR 5, 2014 01:00 PM CDT   
   Debunking Alcoholics Anonymous: Behind the myths of recovery   
   From "One day at a time" to "hitting bottom," two AA critics argue the group   
   is based on bad science and logic   
   DR. LANCE DODES AND ZACHARY DODES   
    Share  810   101  542     
   TOPICS: BOOKS, ALCOHOLICS ANONYMOUS, ALCOHOLISM, EDITOR'S PICKS, ALCOHOL, AA   
   IS A MYTH, LIFE NEWS   
      
   Debunking Alcoholics Anonymous: Behind the myths of recovery   
   (Credit: DonNichols via iStock/Salon)   
   Excerpted from "The Sober Truth: Debunking the Bad Science Behind 12-Step   
   Programs and the Rehab Industry"    
   Myths have a way of coming to resemble facts through repetition alone. This is   
   as true in science and psychology as in politics and history. Today few areas   
   of public health are more riven with unsubstantiated claims than the field of   
   addiction.   
   Alcoholics Anonymous has been instrumental in the widespread adoption of many   
   such myths. The organization's Twelve Steps, its expressions, and unique   
   lexicon have found their way into the public discourse in a way that few other   
   "brands" could ever    
   match. So ingrained are these ideas, in fact, that many Americans would be   
   hard-pressed to identify which came from AA and which from scientific   
   investigation.   
   The unfortunate part of this cultural penetration is that many addiction myths   
   are harmful or even destructive, perpetuating false ideas about who addicts   
   are, what addiction is, and what is needed to quit for good. In this chapter,   
   I'd like to take a    
   look at a few of these myths and examine some of the ways they impair efforts   
   at adopting a more effective approach.   
   MYTH #1: YOU HAVE TO "HIT BOTTOM" BEFORE YOU CAN GET WELL   
   This common myth essentially says that an addict needs to reach a point of   
   absolute loss or despair before he or she can begin to climb back toward a   
   safe and productive life.   
   The most common objection to this myth is simple logic: nobody can possibly   
   know where their "bottom" is until they identify it in retrospect. One   
   person's lowest point could be a night on the street, while another's could be   
   a bad day at work or even a    
   small personal humiliation. It's not unusual for one "bottom" to make way for   
   another following a relapse. Without a clear definition, this is a concept   
   that could be useful only in hindsight, if it is useful at all.   
   A bigger problem with this notion is the idea that addiction is in some   
   fundamental way just a matter of stubbornness or stupidity--that is, addicts   
   cannot recover until they are shown the consequences of their actions in a   
   forceful enough way. This is a    
   dressed-up version of the idea that addiction is a conscious choice and that   
   stopping is a matter of recognizing the damage it causes. I have said it   
   before, but it bears repeating: if consequences alone were enough to make   
   someone stop repeating an    
   addictive behavior, there would be no addicts. One of the defining agonies of   
   addiction is that people can't stop despite being well aware of the   
   devastating consequences. That millions of people who have lost their jobs,   
   marriages, and families are    
   still unable to quit should be a clear indication that loss and despair, even   
   in overwhelming quantities, aren't enough to cure addiction. Conversely, many   
   addicts stop their behavior at a point where they have not hit bottom in any   
   sense.   
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   There is a moralistic subtext at work here as well. The notion that addicts   
   have to hit bottom suggests that they are too selfish to quit until they have   
   paid a steep enough personal price. Once again we get an echo of the medieval   
   notion of penance here:   
    through suffering comes purity. Addicts no more need to experience   
   devastating personal loss than does anyone else with a problem. Yes, it can be   
   useful when a single moment helps to crystallize that one has a problem, but   
   the fantasy that this moment    
   must be especially painful is simply nonsensical.   
   Finally, the dogmatic insistence that addicts hit bottom is often used to   
   excuse poor treatment. Treaters who are unable to help often scold addicts by   
   telling them that they just aren't ready yet and that they  should come back   
   once they've hit bottom    
   and become ready to do the work. This is little more than a convenient dodge   
   for ineffectual care, and a needless burden to place on the shoulders of   
   addicts.   
   MYTH #2: YOU MUST "SURRENDER" YOUR WILL TO GET WELL   
   Here we have another pillar of the Oxford Group, AA's theological forerunner,   
   which preached salvation through surrender to God. In"Alcoholics Anonymous,"   
   this idea is implied, if not expressly stated, in steps 1 and 3, which   
   respectively recommend    
   admitting powerlessness and making a decision "to turn our will and our lives   
   over to the care of God as we understood God."   
   The first problem with this idea is its overt religious flavor. I have covered   
   the many ways that addiction is a problem of the mind and not of the spiritual   
   soul. "Surrendering," in the sense that addiction organizations commonly   
   understand it, means    
   abdicating power to a presence greater than oneself to attain guidance. It's   
   not surprising that many addicts chafe at this notion, not least because it   
   requires a belief system that may not jibe with their own.   
   A bigger problem is that surrendering is tantamount to agreeing that one is   
   incapable of managing one's own life. AA's literature ties this idea once   
   again to a moralistic adage: "Our whole trouble had been the misuse of will   
   power." Surrendering becomes    
   a way to toss out a useful sense of selfhood or agency precisely when it's   
   needed most.   
   And of course the very notion of surrender is problematic when viewed through   
   the prism of a more psychologically sophisticated understanding of addiction.   
   As I outlined in chapter 5, the emotion that precipitates addiction is   
   helplessness. Addicts find    
   certain forms of helplessness utterly intolerable, and the addiction is an   
   effort to reverse that. Asking them to surrender their free will in response   
   to this problem is diametrically opposed to what they need to do: feel   
   empowered. As we saw in the    
   first-person accounts in chapter 6, the dissonance created by this emphasis on   
   surrender is one of the big reasons so many addicts don't get better in AA.   
   MYTH #3: COUNTING YOUR DAYS OF ABSTINENCE IS A USEFUL THING TO DO   
      
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    * Origin: you cannot sedate... all the things you hate (1:229/2)