Wired has an article up about Alcoholics Anonymous.
I just added my rant/response, below the jump:
What we do know, however, is that despite all we’ve learned over the past few decades about psychology, neurology, and human behavior, contemporary medicine has yet to devise anything that works markedly better. “In my 20 years of treating addicts, I’ve never seen anything else that comes close to the 12 steps,” says Drew Pinsky, the addiction-medicine specialist who hosts VH1’s Celebrity Rehab. “In my world, if someone says they don’t want to do the 12 steps, I know they aren’t going to get better.”
I think the “tell” in the Wired article is the writer’s insistence that we don’t know how it works. I get that because of the venue (Wired), a puff piece in on the 75th anniversary of Alcoholics Anonymous has to seem more skeptical and literate than the sort of article you’ll find in your local Bee. And it is. Kinda. And, as a piece of journalism, it’s got to appear to approach the subject with some objectivity. Look, it’s not as if I expect anyone but a handful of us outlying, alcoholic-murdering cranks to go balls out against AA. So, I’m not going to cry about every article that doesn’t sound as if it were written by me. There are hundreds of Happy 75th AA pieces out there that we didn’t link to.
But, Wired? Jeezus. Was this meant for the Fortean Times by chance? There must be some mistake.
The thing is that the foundational question, “How does it work?” is loaded – assuming right off that AA works, and that there is something beyond our mere mortal understanding that makes it work. The question exposes the author as a softball on this subject.
It would occur to any smartypants that perhaps AA works for some people because people who are ready to quit drinking congregate there, because… that’s where we’re supposed to go. Anyone doing an objective piece on AA would have to acknowledge this bit of obviousness.
You’ll also have to take into account that nothing else has popular endorsement and that there are no other options for most people. People who are already going to quit drinking will find a way – and this is pretty much all we got. And it is endorsed. And people are sentenced. And your wife will kick you out unless…
Either this simple stuff didn’t occur to the author, or it did and he chose to ignore it. And if he chose to ignore it, did he ignore it because it didn’t jibe with the propagandistic intent of the piece, or because it didn’t jibe with the sensationalistic “Or Could It Be… Satan!” intent of the piece? Anyway, I expected something better from Wired, which is why I linked to this article.
Well, no… I don’t. I guess I really don’t. I don’t because I don’t think that alcoholism and addiction treatment in general are on anyone’s radar. People don’t go there, except to say, “Isn’t that good what Those People do, when they become Those People? See how they do? Very good! We don’t understand it!” And I think that’s why AA gets the pass it does. And perhaps that’s where this writer is coming from – though I doubt it – just because of the stuff he ignores and glosses, and because of the stuff he chooses to emphasize.
It starts with the human interest element, and then the standard Bill W. as modern-day (He cried out!) prophet bio, but it really kicks off with the quote I opened with. We don’t know why it works, but the most popular addiction specialist in the country says that people who resist the steps won’t get well, and don’t really want to. Then Koerner gets a little sciencey, for the sake of objectivity (relapsing rats?). And, finally, he leaves us with a couple of thoughts.
First,
“A person’s openness to the concept of spiritual rebirth, as determined by their neural makeup, could indicate whether they’ll embrace the steps. Last September, researchers from the National Institutes of Health found that people who claimed to enjoy “an intimate relationship with God” possess bigger-than-average right middle temporal cortices”
Get that? Spiritual people have bigger brains. I wonder how this would explain my sudden embrace of Intelligent Design.
And, second, the standard drunkalog boilerplate:
“I always thought I was too smart for AA,” a bespectacled, Nordic-looking man named Gary shared at a meeting in Hell’s Kitchen this past winter. “I’m a classical musician, a math and statistics geek. I was the biggest agnostic you ever met. But I just wrecked my life with alcohol and drugs and codependent relationships.”
And now, after more than four years in the program? “I know God exists,” he says. “I’m so happy I found AA.”
Maybe one day we’ll discover that there’s a quirk in Gary’s genetic makeup that made his prefrontal cortex particularly susceptible to the 12 steps. But all that really matters now is that he’s sober.
See? All that matters is that Gary is sober.
Of course, this is just Conversion Narrative: I once was lost, but now am found. We have heard this story so many times: I didn’t believe in God! I was mad at God! I was an avowed agnostic![what does that even mean?] I was too smart! This is how the story is supposed to start. It always starts this way. Always.
And the conclusion of this piece is the ultimate, standard, abdication: Well, it worked for me. I mean, for Gary. That’s really all that matters, right? That Gary is sober.
For every Gary who tries AA, there are countless Garys who fail AA – and in failing, kill themselves or kill your kids. Addiction is a apocalyptic problem, and this kind of flip-ass spiritual bullshit has done nothing but make it worse.
What we do know, however, is that despite all we’ve learned over the past few decades about psychology, neurology, and human behavior, contemporary medicine has yet to devise anything that works markedly better.
We do not know that at all. Works? You mean, AA works better at inspiring a Spiritual Conversion than science does? Because that’s what the purpose of the steps is, right? Not abstinence, but spiritual awakening.
To say that this is still the best we can do – and, further, that we know it – is balls.
We have learned an enormous amount in the last 75 years about how people respond to medications and treatments. We know so much more about behavior and addiction, and we have so much to work with. The fact that we don’t take advantage of it is no vindication of AA or proof of AA’s effectiveness.
Not only does it not work better than nothing, but it has made things worse by actively stymieing research, by fucking generations of addicts in the head, by turning a blind eye to rampant abuse (you’ll notice that Wired didn’t find it at all relevant to mention this stuff), and by allowing a cynical industry to grow around it, institutionalizing this mess.
People don’t fail AA because they’re not ready to do “the work.” They don’t fail because they’re not honest people. They don’t fail because they haven’t hit bottom. They don’t fail because they haven’t had a spiritual awakening.
There are plenty of dishonest, punkass, godfearing AA oldtimers – The Spiritual Big Fish – who will gaslight honest newcomers. People fail AA for so very many legitimate reasons that this Wired author ignores. They fail because their conception of God does not jibe with AA’s conception of God. They fail in AA because their sponsor is the crazy cat lady. They fail because the inmates are running the asylum – as they love to say – and it is not funny.
I wonder why Wired published a puff piece on AA at all. Why bother? If they’re going to do an article on AA, why not a real article?
