the science of 12 step recovery is not the same science that measures how much rain fell last year or double blind laboratory experiments #addiction #aa #na #recovery #mentalhealth #mentalillness
August 4, 2014 § Leave a comment
I came across an article in Salon titled, “The pseudo-science of Alcoholics Anonymous: There’s a better way to treat addiction” Sunday, March 23, 2014.
In the article Dr. Lance Dodes and Zachary Dodes argue that AA and rehab culture have shockingly low success rates, and made it impossible to have real debate about addiction. It turns out the Dodes’ are marketing their book, The Sober Truth: Debunking the Bad Science Behind 12-Step Program and the Rehab Industry. Their book claims to be an exposé of Alcoholics Anonymous, 12-step programs, and the rehab industry—and how a failed addiction-treatment model came to dominate America. The premise of the entire argument is false, in that 12 step recovery programs were never designed to be scientifically rigorous inquiries into addiction and recovery. They were a desperate attempt to stop drinking, and a trial and error method that led some people to stay clean. The rationale for the success of 12 step recovery programs is not that there is scientific proof that the program works, it is that there are people sitting in a room together helping each other stay clean, one day at at time, against complex life challenges and obstacles.
I am a sober drug addict. I came into recovery because I could not stop using drugs on my own. I have attended various 12 step groups over 18 years clean from drugs and alcohol. I know how I feel before I attend a meeting and I know how I feel after I leave. I know how I feel before I work on my steps and I know how I feel after. I know how I feel before I talk to my sponsor to face a difficult situation and I know how I feel after. I know how I feel before I provide support to others and I know how I feel after. Without exception my mind state is changed for the better, and so, consequently, are my actions.
I have problems with the disease model of addiction, but I understand how the creators of the AA were seeking terminology that could help them put the phenomena of alcoholism into words. There are other issues I have with the language and normative culture in 12 step programs, but I attribute those limitations to our lack of development as a culture and as a society, to create a societal response to the pain, suffering, and loneliness that drive addictive mind-states and behaviours (not to mention the secondary reality of physical dependence).
However, in my darkest hour, when I was on social assistance, living in a rented room with no hope and no vision for the future, I could walk into any 12 step recovery room and receive something I could not get anywhere else, a warm welcome. It was that warmth, that recognition that I mattered, that I existed, that made it possible for me to take responsibility and do whatever it took to get well. That also meant pursuing professional therapy at different times to come to terms with trauma from childhood and an abusive marriage.
Our scientific methods were never developed to measure and quantify human emotion and feeling, so the development of scientific methods that can help us understand complex human conditions (as internal and external states; as cognitive, cultural and technological realities) must evolve to meet the challenge. I think the notion of using 18th century scientific methods would be laughable if it were not so injurious to the suffering addict. Before we develop a science for studying addiction and the possible courses that can support real, lasting change in any one person’s life, we must first develop an understanding of how the very concept of science, scientist, and scientific method are socially constructed and inflected with the hidden bias of contemporary social norms. There is a reason that ‘one addict helping another’ has been so successful in 12 step recovery. How can that phenomenon be studied in a double blind methodology?
There are no simple answers to the complex circumstances, internal conditions, and social affiliations that will contribute to helping anyone change the course of their life and become productive contributors to their own lives and the lives of others. We are still grappling with de-stigmatizing poverty, mental illness, and addiction. There is much work to do. Attacking any of the good folks, therapists or programs who are making the effort is more symptomatic of societal ‘change back’ to ensure and underclass of unfortunates, than to move forward to create more equitable conditions for all.