Alcoholics Anonymous

I am writing this essay for the purposes of outlining my own personal observations and beliefs about the core beliefs and practical application of the Alcoholics Anonymous (AA) program.  I will begin by clarifying that this writing is not intended to impugn the usefulness or the efficacy of the program, nor is this meant to deny the good that the program does. Inasmuch as systemic errors with regard to the science of addiction are a part of AA, I believe that the academic correctness of the program has perhaps rightfully taken a back seat to utility. For adherents, the system works so attention to whether or not its components are true is entirely beside the point. Nor is this critique rooted in an aversion to treatment on my part because, although I am currently involved in a treatment plan that includes AA principles, I am in that system of my own free will and I am not compelled to participate in the AA steps apart from attending meetings. If it were my desire to reject the program, I would simply not participate. I would not have to write an essay to do so. The following are my ideas in regard to the scientific validity of the program.

I will begin with the assertion that AA, while largely effective as a means of providing members with a program that can help them attain long term sobriety, is scientifically unsound in areas, especially as regards to its tendencies to positing that the majority of the source of alcohol addiction stems from negative life experiences while either ignoring or denying the influence of genetics on the tendency toward addiction. It is my belief that the reason AA ignores the influence of genetics on addiction is due to the unwarranted fear that if genetics can be shown to have a causal role in addiction, that it necessarily follows that nothing could be done to improve outcomes for addicts. 

The error here is the idea that if behavioral traits can be influenced by genes that give people tendencies, that that is the same as saying genetics control our actions as on a one-to-one correlation. Not only is this manner of misunderstanding demonstrably false, it also does not take into account the idea that, if providing the knowledge that some people have greater tendencies than others to certain actions, it could inform their recovery plan and alert them of the need to be more vigilant than the average person in regard to these tendencies. Think, for example, of a person with a genetic tendency to aggression. We need not conclude that there is nothing to be done about this tendency and that this person should be exculpated for their violent attacks. Rather, we should conclude that this person might require closer monitoring and perhaps be given more severe methods to dissuade them from violent behavior. If the reality is that genetics does play a role in addiction, it would make more sense to use this knowledge for the purpose of fine-tuning recovery efforts rather than ignoring this reality.

I do, however agree that trauma, and specifically childhood trauma, does play a large role, not only in substance abuse addictions, but in other behavioral addictions as well. The identification of the source of these traumas and the resolution, a coming-to-grips with these experiences and emotions, can go a long way to aiding in a person's recovery. In that respect, I am not saying that a focus on genetic tendencies toward addictive behaviors should supplant the focus on trauma-therapy, rather I am saying it should augment it.

My other point is that there exists within the program a tendency to oversimplify psychological tendencies to trite phrases (the tendencies of rationalization and self-deception are reduced to being called "stinkin' thinkin'", and the like. Also, one of the most egregious examples of the existence of pseudoscience within the program is the concept that alcohol addiction is the result of an allergy (taken from the founders of AA). Anybody who actually knows how to science knows that an allergy is when the body misidentifies a benign substance as harmful which results in physical reactions that would normally work to dispel or combat these substances. Whatever else might be said about alcohol addiction, it is not and never was an allergy. It is instructive to note, however, that the AA program was developed long before neural imaging was available to show exactly how addiction affects the brain and, in all likelihood, this disinformation was included in the program with the intent of providing a benign falsehood that would help convince people that there was a medical basis for their addiction which would aid them in their long term recovery. In this viewpoint, it is not important that the principles being put forth within the program be scientifically correct, it matters only that these ideas are helpful in the battle against addiction. It is the opinion of this writer that the more scientifically literate people involved with the program are fully aware of the deception and allow it to prevail due to its utility.

My final point is that the efficacy of the twelve steps themselves cannot be properly assessed given that the promotion in the belief in a higher power and the value of the communal meetings of AA members are an invaluable part of the program and it is impossible (in my opinion) to assess the value of the steps themselves apart from the higher power belief and the meetings since all these elements work together. I venture to say that any reasonably contrived program of twelve other steps might be just as effective as long as the higher power concept and the meetings were included in the program. I think the value of the step program is most effective in that it keeps the members focused on their recovery on a day-to-day basis and keeps them interacting within the AA community and it is reality that makes the step program effective rather than the steps themselves. That said, there is undoubtably much value within the steps and inasmuch as these steps are helpful, finding utility therein does not require slavish attention to the order in which they are performed.

I am getting bored now so this is my concluding sentence. Except here is another one. And with that, I'm done,