|Alcoholics Anonymous - Logical Thinkers Need Not Apply|
I. Why What You Think about Alcohol Probably is False
I should like to discuss three tentative constructs. These ideas have to do with the phenomenon of Alcoholics Anonymous and its generally accepted philosophy, which most Americans unreflectively and unreservedly probably believe are "correct." In other words, because of various social and cognitive conditions, we accept various ideas about drinking, and most Americans accept AA to be the expert on drinking.
For your consideration, I would like to suggest four facts about AA that are opposite how most people think of AA:
1. Alcoholic Anonymous can't work;
A fourth construct is even more outrageous, but it can not be dealt with completely in this paper and will be discussed at another time:
4. Whatever AA is about, it is not primarily about drinking.
I have come to conclude that AA is like a decrepit old billboard calling attention to itself, which obscures a perfectly healthy, natural, and accurate view. But the billboard is always there, and because it is so commonsensical that it is there, that we have come to conclude that it not only should be there, but that it is good that it is there. But the billboard is shoddy, decaying, and should be torn down.
II. Why AA can't work
A Logical Approach
According to AA, if I ask you, "are you an alcoholic?" you are an alcoholic if you answer either (1) "yes," (confirmation), or (2) "no" (denial). The third answer is equally problematic, because, of course, if you answer, (3) "I don't know," then the answer would be, of course, that you are still an alcoholic. Logically, this is absurd.
Three different answers to a question can, of course, if you want to do logistical jumps, mean the same thing; but such leaps of logic counter the Socratic, Platonic, and Aristotelian traditions on which any Western philosophy or science is built. When you insist that "yes," "no," and "I don't know," can not mean simply, "yes," "no," and "I don't know," but really a "yes," "yes," and a "yes," it doesn't seem too much to say that you're in a bit of trouble of finding out any truth. If there's only one answer in three contradictory forms, why ask the question in the first place? At best this way of asking questions is useless; at the worst it is dishonest. The logical thing to do would be to find new or better questions which have answers that mean what they say. This AA -- for reasons to be seen -- stubbornly refuses to do.
You see, the essential problem in AA's curious way of putting things is the definition of what is an alcoholic. More simply, the most obvious problem is that there is either unclarity, dishonesty, or just a plain error in these questions. Here's an example: Let me ask you, (1.) "Have you accepted Jesus as your personal savior?," (2.) "When did you stop beating your wife?", and (3.) "Why is the sun as blue as an orange?" A short reflection will reveal that there is such a thing as insincere or erroneous questions. All these three questions rely on a premise which may or may not be true: that you are indeed in need of "saving," that you are "a wife-beater," and that the sun is capable of being as "blue" as an "orange." In point of fact AA asks what appears to be a sincere question, which has three possible answers, but only one correct answer, "yes." In this case the question is, at best, useless, and at worst, dishonest. As we shall see, the error is that there is such a thing as an "alcoholic" in the first place.
A primary line of AA thinking really considers everyone to be an alcoholic. As absurd as it seems, this is actually maintained in many of AA people's belief systems. Hear me out:
The pro-AA person consciously is likely to balk at admitting openly that everyone is an alcoholic. Indeed, he or she is likely to disagree, maintaining that there are really three genuine answers to the question. Concerning alcoholics: There are people who are, and there are people who are not alcoholics. Those who do not know may sincerely not know they are alcoholics; for instance, they may never have wanted or been in a socially approved position to take a drink of liquor, or they might have gotten drunk once and have forsworn liquor, or they might be labeled "heavy drinkers," or they might be dope fiends who don't need alcohol, and so on. Cloistered nuns, Native Americans of the 12th century, and heroine addicts all can state truthfully that they do not know if they are alcoholics. Let us assume for a moment that there is such a thing as an "alcoholic" and that there are some who are and some who are not this creature.
According to the AA "religion" you are required to begin every statement in meetings with "Hello, I am (first name), and I am an Alcoholic." This phenomenon is indicative of how important this concept is to the religion of AA Apparently there is some unproved and unsupported "genetic" disposition in some people to be alcoholics. It is, at the very least and most, part of their being, like brown eyes, or flat feet. If that is true, so the argument goes, there must be people who are not alcoholics, who don't have that genetic switch.
A second and rarer viewpoint holds that we all must be alcoholics to some extent, though some have "it" "in control," and a second group do not have "it" "in control." Again, in the second case, we revert to a situation where we have a "disease" model of alcoholism. This disease model was central to the formation of AA sixty years ago; it did not need the concept of a "genetic disposition" at that time, but, of course, has readily accepted this construct, no matter how unbounded in empirical evidence it is.
However, we immediately have several problems if we follow AA's line of thinking.
The first difficulty is sheer inconsistency: As discussed above, you can't ask a question that has three answers which somehow are only one answer -- at least not most of the time in the real world. Furthermore to do so smacks of not wanting the truth, but of intellectual entrapment -- Remember the Jesus, the wife beating, and the blue sun questions. To ask such question implies that the question is invalid.
Secondly, there is a violation of the law of proximate inferences: Because two phenomena occur at the same time does not indicate causality. Because a person drinks too much does indicate in any sense that there is a defective gene or even that he is "diseased," anymore than believing that when you open your eyes in the morning causes the sun to come up over the horizon.
Thirdly I would like to point out Occam's Razor or the Law of Parsimony: Because a person drinks too much indicates only that he drinks too much, the phenomenon of a person "drinking too much" is more only just "drinking too much" than it is any thing else, or any larger phenomenon, such as bringing in "genetic" or "diseased" complicated and unfounded models.
And, I should add, that because such a pattern of individual drinking may be quite destructive, does not in any sense add to the quality of what drinking in itself is. No geneticist would maintain, as does AA, that there is a gene that is a "switch" for any behavior. For various reasons (mainly because AA is an evangelical organization), AA needs to maintain that our environment -- a world that is often absurd, cruel, grossly unfair and arbitrary -- simply has no bearing on the so-called genetic "alcoholic switch" being on or off. This is patently absurd. In point of fact, most people who drink too much do so most of the time because it simply makes them feel better than they would without it, not because they are some creature named an "alcoholic" who has some genetic "switch."
You do not need the term "alcoholic" to explain "drinking too much," even if a person is drinking him- or herself into illness and death. You do not need to ignore "the world" as a contributive factor to human despair. There is no evidence that one or several genes, even if found, could explain the phenomenon of drinking. And, should your prove that even if people genetically drank too much, that this is a disease worth curing with a belief system, you still don't need AA or "alcoholism" to explain drinking.
This is getting ahead of things, for now let us say that, from a logical position, AA can not work. AA defines drinking in a complicated, unscientific and illogical manner, and you can't base "treatment" on a falsehood and expect such a treatment to work. AA does have a great deal to do with mid-western Protestantism. AA is prescriptive, not descriptive; that is its foundation is based on what ought to be true, not what is true.
Why AA Can't Work: The Medical Approach
If you do not want to go the philosophical route to deconstruct AA, you can go the historical or medical route. It is central to AA that "drinking too much" is a disease with the pseudo-scientific name, "alcoholism." Without much scientific evidence, the medical establishment has allied itself to AA because it seems to be "the only thing that works."
Historically, simply let me point out that there is no reason to suppose that what two Mid-western evangelical Christians in the early to mid part of this century think of as normative constructs, are normative for anyone else, either then or today. Secondly, medically, let me point out that there is no reason to suppose that what medical "authorities," given our American penchant to believe medical authorities, say is true, is true. Because something seems to us commonsensical, does not, in any way, indicate that it is commonsense.
Let me give an example. If you presented certain symptoms of stomach pain until quite recently, you would be diagnosed with something called an "ulcer" Indeed it would be seen as having to be true: There'd be a hole in your tummy, in which case you'd be in a lot of trouble. You would be advised that this was due to "stress," and your remedy would to have part of your stomach removed (at the most radical) or instructed to drink lots of milk (at the least invasive). Now neither removing parts of the stomach nor drinking milk has anything to do with ulcers, because "we" -- according to medical knowledge as I understand it as a layperson -- have learned that this phenomenon is caused by a virus.
But both doctors and patients for decades believed that this was commonsense.
Right now some people suffer from a disease that makes them loose their hair. The common cause is seen as "stress." Of course there is all probability that there is, in reality, some undiscovered cause which we simply have not found yet. But the medical philosophy seeks "causes"; it abhors the vacuum of "not knowing." A weak and unsupported "cause" is better than not knowing at all. Here the Mayo dictum helps us clarify matters: The more cures for a disease is in inverse proportion that any of them will work.
If drinking alcohol is a problem for you, you have a duty to figure out what is going on. Yet medicine may not be the agency to help you. In fact, the purpose of medicine is not to find the truth, nor to help you find the truth of your situation. In fact medicine does not seek primarily to study disease, nor does it seek to arrive at any understanding of health; medicine's purpose is to eliminate disease, nothing more and nothing less. If medicine wishes to talk of truth, or to study disease, or to speak of health (which it almost never does), it is primarily in its dealing with what it labels disease or "non-normalcy" (and this is important) as it is found in the real world as doctors define it. Where disease is absent, there is no need for a cure, and certainly not for study of any bodily phenomenon except that such phenomenon is defined by its pathology.
Here's an example that might help: If the majority of the people walked around with a green lump on their foreheads, and if this caused a mild depression in most, medicine would not study it, because the green lump and the mild depression would be the stance, the normalcy, the starting point for examining those few diseased people who had no lumps on their heads and walked around with grins on their faces.
Medicine literally does not see what is not a disease, or that which can not, in some way, become diseased. And once a phenomenon becomes problematic, it can see it only through its operant lens, "disease." To put it simply, to a man with a hammer, everything seems a nail; to a man with a pen, everything seems a sentence; to a man with a stethoscope, everything seems a disease. The problem is of course compounded because doctors do not talk to philosophers, poets, or even (surprisingly) scientists. Doctors talk only to doctors.
There is a problem with the medical model here, as much as there would be a problem with any model: "Normal" is defined in a simplistic and unnatural way, indeed either (1.) as opposed to what is diseased, or (2.) by what is normal, but can become diseased. Homosexuality, masturbation, having red hair, hysteria, "the vapors," apoplexy, and on and on an on, were all diseases at one time, and it is sheer dogged stupidity to assume that we're any better qualitatively, using the same medical method, than we were years ago We may know that wiping scalpels during surgery on the lapels of coats (as doctors did years ago) will certainly infect the scalpels with "germs," but this is quantitative knowledge. There is no reason to assume that the qualitative way that medicine looks at phenomenon is not as flawed now as in the past. That medicine has done "great things" can not be denied, but that it is a way of looking at things that has errors built into it, also can not be denied.
I repeat here in passing that medicine, as indeed all sciences, take the world as it is as normative. What should be is what is experienced by the masses of (healthy) humanity or what is not experienced by the minority of (diseased) humanity. Healthy and diseased are two labels which must be applied to all phenomenon, whether it be to a bad heart, a case of indigestion, or drinking. Doctors can not accept that most people drink for perfectly clear reasons; they must label those who have a "problem" as "diseased." In fact there is nothing else that they can do.
Doctors the medical establishment can never understand that the world is an absurd, unfair, or occasionally even a horrible place. If this were true, drink would be seen as a cure. No less that the formative psychologists Henry .Stack Sullivan and Erick Erickson have pointed out that without drink, civilization could not occur. The term "disease" used in a medical sense, referring to alcoholism is not only unhelpful, but untrue.
Here's a dictum: Just because it seems as if "alcoholism as disease" is a useful meaning making system, it does not follow that is either a valid or invalid concept. It is merely as valid as any other complicated phenomenon without any empirical basis; in fact, it is as valid or as invalid as such meaning making systems as "witchcraft," "cancer," "astrology," "the soul," "Id," "dysfunctional," "gravity" or so on. "Alcoholism" is a complicated set of constructs whose only justification is that it seems "right" that there is such a complicated thing. If by "alcoholism" you mean "lots of people who drink too much" you can be somewhat correct, but if by "alcoholism" you mean a complex quasi-disease which is yet not understood, you violate not only logic but any scientific system of inquiry.
Here I pass lightly over an allied discussion in which I would prove that even if some "alcoholic gene" were found (a big "if"), it would not mean anything at all, certainly not that "alcoholism" was a "disease," anymore that a tendency to be sexually attracted to the same sex, have blue eyes, or be able to run fast, or to play the violin really well.
But let's go further. Let's assume against all reason and evidence that there is such a disease and it is called "alcoholism."
The "disease model" is particularly un-useful in labeling a person "alcoholic." For, if "alcoholism" is a "disease," as many have pointed out, it is a disease that operates like no other disease on the planet earth. Such a "disease model" is so patently absurd that it hardly needs description. "Cancer" patients are not held responsible for their illnesses; they don't carry around little key chains saying "I am responsible" like alcoholics do. Hepatitis sufferers are not sent to twelve step programs, but are treated with drugs. And, may I point out that there are no cancer-drivers out there causing accidents death and havoc. No drunks and drinking are quite another thing than misshapen cell clusters.
The essential problem is that alcoholism can't be a disease, or we'd have to change what "disease" was until the concept was no longer useful or accurate -- until what we mean by "disease" is not longer "disease." If "alcoholism" is actually a disease it has deconstructed the notion of "disease" until it is useless.
I am sure that readers who have been converted to the AA mindset, may think that I am only engaging in some elaborate form of "denial." I have no doubt that, according to AA, I am in denial. I just think that my way of thinking is more grounded in logic, reality and common sense than theirs is.
In point of fact AA can't work, because it is inherently illogical and un-empirical -- and that's saying a great deal. We may want it to be true. It may seem very commonsensical. But because it seems to make sense, doesn't make it to be true, certainly not anymore than witches cause bad things to good people, or that bad air causes disease, or that mental disturbances are due to a disturbance of "humours" in the body, or that Jesus is your personal savior, or that you should stop beating your wife, or why you should explain to me why the sun is blue. This brings me to the next point.
III. AA Just Simply Doesn't Work
It is simply amazing, if you keep an open mind, that AA is recommended as the only "cure" for alcoholism when it appears to have absolutely no effect on people. If AA were the United States national highway system, we would be a country of wrecked cars with, perhaps, a fraction of the tens of thousands of automobiles per state running around. Let me give two personal observations to clear the air:
(1.) no person has "given up" drinking gave up drinking primarily because of AA; and
AA is that big gaudy billboard -- which should have been torn down long ago, that obliterates our view of that charming scenery behind it, the scenery of truth. Because it's there, doesn't mean it should be. If you substitute "cigarette smoking" for alcoholism, you quickly realize that almost no one quit smoking because of a twelve-step program. And overweight people don't loose weight either because of these programs when aimed at them.
In point of fact, AA just doesn't work. Even AA is quite up front about it outrageous failure rate, a rate so outrageous that it seems to indicate that, whatever "it" is that AA is doing, doesn't work. But, AA argues that (1) because it is the only plausible model of explaining the phenomenon of drinking "out there," and (2) because that a very few people who attend AA stop drinking, it must be at least the only effective desperate measure that can work. This is, of course, patently absurd.
Reverse the situation. If a person drinks too much, he or she is almost certainly to be sent to AA; that person might get well, and AA absurdly gets the credit. I point out the well-known and documented fact of social sciences that as many people with "problems" get better, as many get worse, and as many stay the same, regardless of whether they have been "treated" by a psychologist or psychiatrist. Why should we assume AA has even a remotely successful track record, when it patently doesn't.
From my subway stop in Manhattan, it is possible for me to pass one AA meeting place on my way home, and, should I want to go four blocks out of my way, to pass where another takes place. One has five meetings a day, the other has three, a total of seven. At the same time, without going out of my way, it is possible to pass five liquor stores, all of which are open, by a conservative estimate, ten hours a day. They obviously do a successful enough job to stay in business in what happens to be an extremely well-populated neighborhood. At the two local AA meeting are, typically, twenty to thirty persons -- People who are, I might add, desperately attempting to convince themselves that AA works. If you consider the vast amount of people who support these liquor stores, and the limited amount of people who are (mostly unsuccessfully) attending AA meetings, it seems valid to conclude that there are a heck of a lot more people drinking "successfully" than those who are attempting to convince themselves that they are diseased and that only a religious cult can help them.
But. even if there were people who were "alcoholics" -- rather than there being just people who drink too much -- then the remedy for such an astounding "disease" is highly ineffective. How many AA meeting goers does AA fail. The answer is, by AA's own admittance, an astounding number.
Most interestingly is the fact that, for AA's consistent and outrageous failure rate, blame goes not to AA philosophy or to the organization or to the intellectual or affective system, but to the "diseased" individual who can not "get with the program," an irony surely, as the vast majority never, ever, get with the program. Again, imagine blaming a cancer "victim" for dying painfully because he has not "gotten with the program" of a particular hospital he has submitted himself to.
Quite frankly, no matter what anyone may think about it, AA simply does not work for the vast majority of people who go to it for help. If AA were in the business of repairing cars, or selling umbrellas, or baking bread, it would be out of business within a month. Furthermore there is no reason to suppose because the vast majority of people "out there" think of it as "the only" answer in any way makes it a "right" answer. In fact the overwhelming majority of people who drink never go at all.
A desperate answer does not make a correct answer. An ineffective answer is no answer at all.
IV. AA is Irreligious
As stated above, AA was founded by men (the emphasis is intentional) with an evangelical background. The structure of AA is patently evangelical, which, to put it briefly, posits an all-controlling all-powerful god who deems some to salvation and some to damnation. By relinquishing an evil "self" to the will of the almighty, the individual can be "saved." Substitute "drink" for "God," and you'll understand how clear this is: I am powerless before ______ . In point fact no human being is ever powerless. Indeed it is impossible for a human being not to make choice all the time. I would argue that it is inherent in the definition of "human" to make countless choices.
Quite simply, if there is a god like AA's, this isn't my god. If I believe in a god, I believe in a god who has created humanity to participate in God's act of creation. This notion is in every sense one of uttermost Christian conservatism. Pick up any Bible, or, say, the (protestant) Book of Common Prayer, or a Catholic Catechism, sorry I'm not up on Judaism or Islam -- flip to any page at random, and you will quickly realize that there is nothing in the Judeo-Christian tradition that posits any human as being totally powerless, even in the face of the supposedly most powerful force in the world, God himself. An exception is if you are a fundamentalist, then you are a totally corrupt individual, powerless, in need of saving.
It seems to me, that, if you were inclined to believe in it, that God deliberately allows humans to make even bad choices if they insist. God, if you believe in him (or her), deliberately created a morally, socially, and personally ambiguous world which must be negotiated. God demands that every person construct a life; he or she may do a bad job of it, but construct a life he or she must. Indeed one can not not construct a life; one can not not make any number of choices. In fact, to be human is to choose.
The ability to choose in most of life's situations is in no way evangelical, and it would not play well in the place where AA was born in a church basement after Prohibition was repealed. But recognizing that a person has the ability to make choices, choices to love, to work and to change for the better, is essential to any healthy way of living. It seems to me inconsistent, if there is a God, that he or she has created "dependent" children lacking all power to organize their lives or to make meaning of the world. Being "helpless" is not a natural, nor healthy, aspect of humanity.
But I would like to point out, that the vast majority of people for whom AA is a negative force, agree with me. For many it is patently absurd to "cast their cares upon" Jesus, God, or any divinity. If you believe in a god, terrific, I am sure such a belief can help you. But I know that that mental, physical, economic, and social health involves taking responsibility for my actions and intentions. Not an easy task, though.
This irregularity comes to mind: according to AA, the "alcoholic" is to carry around a key chain with the words "I am responsible" but at the same time to believe the totally contradictory dictate "I am powerless." This is sheer absurdity.
Ten Tentative Ideas to Attempt to Move the Discussion Forward--
So what to believe? Let's put it this way: Once we suspend the firm conviction that "what we believe" is true because "we believe it along with a lot of other people," we find that much of "what we believe" was not "true" at all. We also, in this freedom of inquiry, are able to discover many concepts which we would not considered possible before. To paraphrase Socrates, "Let us seek to find what is true, and if we find that what we thought is not true, let us be comforted by the fact that we know that what we thought what was true, is not."
Suppose that a doctor or a psychiatrist was as reliable as the bartender in your average bar, and vice versa. Free up your mind a bit to attempt to shed some convictions that what you think is true is only true because you think it's true, or because everyone seems to think it's true. Think for a moment that the doctor, the psychiatrist and the AA practitioner actually had more of an interest in making you believe what they told you than the bartender had in serving you a drink. If you get drunk, the bartender will stop serving you, and this should never happen or you do have a problem, it is only because the bartender knows that to continue drinking is very bad for you. The bartender pretends to no other knowledge that you really shouldn't have another drink right now. The doctor, the psychiatrist and AA, on the other hand, can not stop serving you their advice, no matter how useless or detrimental it is to you, no matter how destructive, because they would have to invalidate their own beliefs, and this they can not do. They would rather see you harmed than change their precious belief-systems.
Imagine for a minute that it may be true that some people drink too much because their lives are not going well. Imagine for a minute that the problem is not "alcohol," but "life." Imagine that alcohol is a time-tested "cure" for the problems of life, while admitting that, like all cures, it carries a price and a danger.
Is it not then absurd that if I went to a "doctor" and was "diagnosed" as "depressive," that it would be alright, indeed mandated, that I take several pills per day to "cure" or "manage" this "disease," and that I would have to take these pills for the rest of my life; but that, if I attempted to control the same "disease" with alcohol, not only would I be an "alcoholic," but that such a "disease" would be progressive. This is patently absurd. It is absurd because even the AA religion allows (sometimes, anyway) that many people are not progressive alcoholics. But it is even more absurd that a medication that has been around since human hunters and gatherers settled down should be an "evil" while an relatively untested pill is a "benefit." Doesn't make sense.
Speaking personally, I have never landed in a hospital for "drinking," but I have for taking pills prescribed by a doctor. And I can hardly pass up commenting on the phenomenon that there have been a great many pills pushed by the official medical establishment these days, that, while they may or may not be effective for the disease they address, seem to have harmful -- if not deadly -- effects. Miracle drugs are withdrawn monthly. I am not saying that the drugs a doctor prescribes are necessarily bad; I am only saying, based on my experience, that they are certainly as risky as taking a drink
Equally absurd is the construct that if I am "suffering" a "pain" such as depression or anxiety, that the problem is with me and not with a world that, at best, functions with imperfection. AA and the medical establishment ignore that pain, poverty, suffering, loss, disease, and sorrow really can affect a person's life.
I can not fathom why it is medically acceptable (if not preferable) to prescribe drugs that have been in existence less than three years to "cure" the "disease" of "depression" and "anxiety," while a remedy that has been in existence since human beings settled down from huntering and gathering into stable groups. Indeed, as has been pointed out, the first thing the !Kung people did when they settled down into farming was to brew beer.
Indeed it is more atypical (if a thing can be "more" atypical) for a person not to drink alcohol than to drink alcohol, and it is foolishness, religious fundamentalism, medical incorrectness, and absurdity to assume that such a phenomenon as drinking should not be the norm.
At this point you will probably have dismissed my argument: It can't be true. It's too outrageous. It's too un-commonsensical. I can only add that you only need to take a walk around to see where unreflected "commonsense" has gotten most people most of the time. If taking a walk is too much, pick up a newspaper or flip on the t.v. There you will see and hear the aggregate "norm," and it is none too pretty.
To cut this discourse short, let me give ten tentative constructs which you might consider or not to consider. Some of them might be true:
1. "People who drink to much" are only "people who drink too much" more than they are anything else.
The following are not part of the above discourse, but, I think, are provocative enough to include from an anti-AA perspective:
5. The less alcohol is available, the more people will drink; the more alcohol is available, the less people will drink. Human nature loves, above all, freedom to choose. Abstinence encourages failure.