AA & 12 steps are not good

I have had academic and research issues with AA for years. Here are my five main reasons I think AA is terrible. However, I have chosen to restrict my criticism. A close friend Sue, brought up some quotes out of the “big book” of which just plain irritated me. She tends to remind me of good points I even try ignore. In all honesty, I had forgotten about them. I tend to attempt to not clutter my mind with non-sense that is not scientific and useless.

Here is the reality…. I see people who adhere to the dogma of AA just like religious people. They ignore the research and science that completely debunks, refutes and shows its just plain wrong. Instead, AA, people like religious people back track, and try to salvage what they can as the science undermines their beliefs, showing its just not true! They say things like, “take what is useful,” “it’s a metaphor,” “you don’t have to believe it all,” “don’t take it literally,” blah blah blah….As stated in point 1 (see below) decades of research and no adaptation! That is an Anti-Science position period, end of statement. So, in light of Sue’s astute points privately made, I will not waste my time, rereading the “big book” (which I already did academically) and then deconstructing and tearing apart with research citations the dogmatic, blind adherence to ideas presented. Simply a waste of mental rent, here the the top five!

1. The 12 step model published in 1939, has not been adapted in now officially… 78 years. This is completely inappropriate in science. Models or theories of which are representations of the naturally occurring world, are best approximations. They are not perfect and should be adapted as research comes in! Come on! We have had over seven decades of research, and are applying the same model, this is ridiculous. Then on top of it the 12 steps treat “hard” drugs, the same as alcohol, sex, and video games. All are under the same concept as “addiction” of which is not properly operationally defined. Not operationally defining it leaves it vague and allows for “wiggle” room and reinterpretation depending on the debate. Addiction is being applied basically to any maladaptive use of anything, those last four words before the comma, actually start to approximate an operational definition.

By the way an Operational Definition is how the concept is measured, and defined precisely. If we can’t measure something then we cannot study it scientifically, that is how science works. Philosophy of science issue there. A simple example will suffice.. If you measure depression on a 1 to 5 scale for study and I measure it on a 1 to 10 scale, these results will be difficult to compare in two different studies. Clearly a 5 on each scale represents something completely different! So, when comparing studies, you need to make sure both groups operationally defined the variable the same/similar way.

2. Same twelve steps apply to all types of people, and addictions. As we know, not all medications work for each person in medicine, one works for me while another one works for you. In therapy, yes we start with a theory, and hypothesis deductively drawn from said theory, but then adapt to every patient. The AA 12 steps don’t do this….It’s the same twelve steps for every person. Yes, I know the frequent cop out is to take from it what is useful…. come on, it’s like people with the bible saying these stories are metaphors when shown via science they could not be true. It’s trying to salvage what you can, grasping at straws. We could also, go to a psychic, church where they speak in tongues, palm readers, astrology, etc and find something useful!

3. It’s a one sided, or as I say half of therapy. You  go in vent, listen to stories, but there is not an expert to “correct” thinking as we do in therapy and see underlying patterns. People vent, yes I admit if you give them measures regarding how they feel after a meeting damn right they feel better! Who doesn’t after venting. The issue is there is not the same substantive change like you find with therapy. People usually go to a therapist after friends and family can’t and have not helped them, people who know them very well unlike randoms in a meeting. Therapists are trained to point out these common errors unique to the individual patient as to how they are screwing things up! So a professional, who is trained to not just listen to a venting session, they instead, actually tell you what you are doing wrong.

4. Unethical
People as stated in the previous 3 points, do all of this and waste for some hundreds of hours of time! They keep going too as they say after treatment “90 in 90” so 90 meetings in 90 days! Oh my god!!!!! If I see a patient therapeutically for that many hours (actually many less with current, research on outcomes) or even just 30 hours lets say. I have to be able to stand before an ethics board and justify why treatment is taking so long! When I was trained cognitive behavior therapy was 15 to 20 sessions, now I have heard outcomes stating 10 to 12 sessions should be expected. What I am saying is it would be better for a patient to work extra hours at their job each week, or an extra shift to be able to cover actual therapy. Instead, I have heard of and met people who have been going to AA meetings for literally 20 years continuously.

5th point just since its irritating to hear…
People say its a support network. Yeah, again it was intended to be more therapeutic, especially historically since back then there were few treatments available and the term was ill defined. Again, its a back tracking method like the bible to hold on to precepts that are frankly just not useful now. If ideas that seem as if they come from AA they are parsed into finer detail. So in reality many times they were not even culled from the 12 Step model to begin with! It’s like freud saying the brain, is ultimately responsible for the mind. Yippee so vague absolutely any neuroscience finding falls under that “prediction.”

All of  these above points are valid and have been written about by other psychologists. So, any professional reading please realize I am not stealing the ideas. I am not taking credit that these five criticisms are of my own invention, but combinations, adaptations, and adjusting what I have learned. Again, attempting to respond with some sob story or personal experience of you or some friend, does not validate the 12 step model. It’s merely an anecdotal observation at best.

A final statement, on that note regarding the statement “it works for me.” Yes, something may work for you. Look at it this way, some intervention may increase your productivity, by 20% lets say, or decrease negative effects by 20%. However, another intervention may help/ameliorate by 70%, or 80% vs your pittyful 20% intervention. I look at this comparative clinical effectiveness of interventions, I get it… AA is free, people may perceive some benefit. I still think it preaches too many dogmatic, anti-scientific ways of thinking that ultimately undermines mental health treatment of drug an alcohol issues. Not even to mention this silly 12 step model is used in more far reaching areas when originally only meant for drinking.

So in summary, AA is dogmatic, like religion, it ignores science. Decades of research have information to give to people. I have never recommended it to individuals, instead I always suggest therapy, and guess what we have group therapy as well, for those who love the group format!

One thought on “AA & 12 steps are not good

  1. I do understand the desire not to clutter your mind with nonsense, however, if you are looking to have any sort of exchange with a person that believes in the unscientific, it is important to channel those concepts in order to communicate with them. Those concepts are central to their belief system and thought process. They can serve as a bridge towards introducing science to the discussion.
    It has not been adapted because it serves a purpose in its present form. They want to reach a specific group. The religious message resonates with their audience for a reason. That is what reels them in. They don’t keep records of who attentions meetings. They thrive on word of mouth success stories. At least, that is what they are known as. They operate from a moral perspective and that influences the methods.
    Because they limit how they approach different people and various addictions, it makes it easier for them to blame the individual for failure. This narrow and limiting vision makes it ease to cast out (Biblical reference) those that do not fall in line. The façade is helping others and there are people that buy in and it works. But there are those that question the approach and they are removed. The idea is not that the approach is wrong, it is the individual that is wrong. That happens repeatedly when people question religion.
    The intention is not to be therapeutic or to be thorough. The venting is the release. The bonding with randoms is their proof of effectiveness. The view is that because of their common need, they can help each other. They can share experiences and form connections, that is sufficient to them.
    It isn’t remotely about efficiency. Their focus is on the repeat visitor. They want to suck people in so they keep coming back. Their idea of a support network is likeminded people coming together to support their approach. It is indeed dogmatic but that reinforces the mentality they perpetuate. It serves a purpose.

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