I recently wrote this post on another message board, but thought that it might be relevant to repost it here on this blog, to explain why this subject is important. It’s easy for A. A.ers to dismiss people who spend time trying to shine a light in there — trying to warn people and offer options — as cranks, disgruntled A.A.ers with resentments, vicious people who don’t care about that one alcoholic who might be saved… I always want to ask these people what, exactly, they think we’re doing. Do they think that the criticism is completely random? Pointless? Without foundation?

I’m never gonna get an answer to that question. But, by way of explaning myself here, I thought I’d copy this post.  Some of my opinions have changed slightly, and names have been changed to protect the insouciant. –ftg

The issue that some of us have with AA and 12-step “programs” is not their spiritual component or the fellowship it involves. You will notice that no one denies anyone their spiritual fortification in this fight. No one scrutinizes your church, say, or takes issue with anyone who would use their personal spiritual path as a foundation for their sobriety. It has to do with the 12-step industry – and despite the fact that meetings are free, this is a powerful industry that makes money, and the conventional wisdom is that it is a sound treatment for alcoholism. There are many addictions therapists trained in 12 step. There are rehab facilities that rely on it exclusively. Courts order people into AA. Therapists who have no training in addictions will recommend AA to their clients.

As I said before, it is the standard, but it is not held to any of the standards that other disease treatments are held to. I hope that this distinction is clear. It is not about any one person’s personal experience with AA. Consider, for instance, the many times you have heard from people who have had negative AA experiences (myself included). The typical response from A.A.ers is to say that the negative experience is an exception. In other words, anecdotes, in these negative cases, are brushed off – while positive anecdotes are treated as all the proof one needs that it works.

In fact, because AA is both an industry and a spiritual fellowship, there are many contradictions that members have to get right with. It demands cognitive dissonance. For instance, they will say that you can take what you need and leave the rest; no one is forcing you to do anything — but at the same very same time, will say that “there’s no middle road” as far as taking the First Step is concerned. These contradictions are endless.

Now, the thing is that, in order to perpetuate itself, AA must maintain a certain fundamentalism. In that sense, it operates like a Multi-Level Marketing outfit (which also has “sponsors”). It has to be able to be duplicated on the lowest levels of the company, scripts must be followed — like a franchise. You have to be in it to win it. As they say in MLM, you can’t fail if you work your business. They say that the whole point of the MLM (like Avon, say) is “women helping women” (or alcoholics helping alcoholics, see?). They will tell you that you are free to manage your business as you see fit, because it’s your business; but at the same time, they push the idea that if you actually want to succeed, you will follow the plan.

If it were a free-form spiritual fellowship community, and if the 12 steps (and all the jargon, slogans, traditions, etc) were merely a guideline, this wouldn’t be the successful industry that it is. Similarly, most of the people who join an MLM are going to fail at it — just as they will at recovery with A.A. They haven’t worked the program. The business model is sound. It cannot fail; it can only be failed. If you don’t succeed it’s because you didn’t commit to the clear plan laid out for you. And the bottom line of an MLM is to duplicate itself as many times as it can.

Anyway, there are many things I think we can agree on. I think that we all want to see people succeed in their fight against their addictions; we want to see innovations in addictions treatments; we care about each other here, and wish only success for each other. We respect each others paths and personal spiritual beliefs. We also do not disagree that spiritual fellowship with other alcoholics can be the foundation of one’s recovery, if it jibes with one’s belief system. We agree that A.A. can provide something important to some people. Those of us who question it are not trying to discourage people from going.

What we are trying to do is point out that the fact that, because AA is not considered spiritual fellowship, but is treated as a program, and not just a program, but the program, 1. people’s expectations of AA and themselves are distorted (“It works if you work it.”), 2. as long as it is treated as the program, then courts, lay people, therapists, and families, will continue to insist upon it, and 3. addicts will see it as their last hope for recovery, and statistically speaking, they will fail, as will their hope.

How about if we get real about what AA is? A few people are concerned with that one alcoholic who might have pinned his last shot at sobriety on AA, read this thread [which turned into a debate about the effectiveness of A.A.], and throw in the towel. However, if we are honest about what it is — if A.A. were honest about what it is — there is no reason for this to ever be the result. As long as A.A. is considered the last hope, it is just as likely that this one person, who pinned his last hope on A.A., ends up finding that it just isn’t for him, and loses all hope for recovery.

If we could lift this taboo, shine the light on AA, show what it is and what it isn’t, which would allow addicts, counselors and families to make an informed decision about it and to be realistic about what it can (support) and can’t (treatment, cure) offer them, perhaps both hope and innovations in actual treatment could thrive.

One major contradiction I see here is that people who are invested in A.A., and who insist that it is not treatment, not a program, but rather a spiritual fellowship, get very upset when it is pointed out to them that — they’re right — it is not effective treatment. How can you both deny that AA is treatment and then get upset when studies show this very fact? If you want to say that A.A.“works” then you have to deny that it’s a just a spiritual fellowship. But when it is pointed out that it doesn’t “work,” then the hackles go up, and the response is that it’s not supposed to “work;” it’s just fellowship. And I’m really not understanding why scrutinizing A.A., in light of the conventional wisdom about it, should be threatening at all. The scrutiny does not effect, one way or the other, whether it is meaningful or appropriate for you. But the scrutiny would certainly effect approaches to addiction treatment positively in the recovery industry, which is what we all want, I think.