“The fact is that most alcoholics, for reasons yet obscure, have lost the power of choice in drink. Our so-called will power becomes practically nonexistent. We are unable, at certain times, to bring into our consciousness with sufficient force the memory of the suffering and humiliation of even a week or a month ago. We are without defense against the first drink.”
– from the ‘Big Book’ of Alcoholics Anonymous, p. 24
The above was written in 1939, at a time when we knew little about alcohol addiction. Sure, we knew how it manifested itself, and we knew the consequences of addiction – but we did not know the true nature or the cause of alcohol addiction. Because of our limited understanding, all that could be done at the time to address alcoholism was to treat the symptoms. There were only theories as to what caused alcohol addiction. At that time, it was a widely held belief that alcohol abuse was a character flaw, and that those who abused alcohol were simply exhibiting their weak moral constitution. This was perfect for AA, as they took advantage of his belief, which thy exploited and perpetuated, just as they do today.
AA fills in the blanks of addiction ignorance much like religion fills in the blanks of scientific ignorance. With religion, “God did it” is the default answer to that which we do not (yet) understand. It is fallacious logic at its finest, and is in a nutshell saying, “I don’t know, therefore I know.” With AA, “spiritual weakness” is the default answer. Why does Mary D. insist on drinking when it continues to ruin her life? Simple. Because Mary is “constitutionally incapable” of being honest. This quote from the ‘Big Book’ states that “for reasons yet obscure”, some people have an inability to stop drinking, yet the book turns around and states that a “spiritual awakening” or “an entire psychic change” will relieve a person of their compulsion. In other words, they are stating that they don’t know why some people can’t stop drinking, but the reason they can’t stop is because they are spiritually weak — “I don’t know, therefore I know.” It is just one of the many contradictions which is AA.
In 1939 we did not know the cause of addiction, or why some people could control their drinking, while others could not. This is one thing the ‘Big Book’ had right, and at the time the it was written, a ‘spiritual deficiency’ was as good of a hypothesis as any. Closer to the actual cause was the allergy theory set forth in ‘The Doctor’s Opinion’. The doctor was wrong, but at least he was on the right track, and it was as good of a place as any to start to find an answer. Fast forward seventy-five years, and much of the ignorance we had about the causes of alcoholism have been answered. Any answers we have found in that time, and any scientific advancement made in the understanding of addiction, has been discovered in spite of AAs fighting it at every turn. It is difficult to advance when the primary group available to help alcoholics is only interested in the advancement of their fellowship, and imposing their a set of arcane religious beliefs.
We now have an understanding of the physiological effects alcohol has on the brain, including how alcohol affects the brain’s pleasure pathways, which were not even discovered until twenty years after the ‘Big Book’ was written. We also know, for example, how alcohol affects the production of dopamine for alcoholics, as opposed to non-alcoholics; and it is this understanding that has led to breakthroughs in the treatment of alcoholism. Knowing the cause allows us to treat the cause, and not just the symptoms, of a disease. One thing we know for certain is that alcoholism is not a spiritual malady, and it is not an allergy. Not that there are not psychological consequences to addiction. Obviously, there are; and it is obvious, as well, that psychological problems often serve as a catalyst, and as a reason a person begins drinking in the first place — but the addiction itself is now understood. It is not obscure.
Drugs like Campral and Naltrexone, which have shown to be effective for many in curbing or eliminating cravings, work on these pathways that have been affected by alcohol abuse; and for most, prolonged abstinence will allow these pathways to revert back to their normal function. This happens regardless of whether a person is working religious steps. The “psychic change” that is referred to in the ‘Big Book’, and is so often repeated by AAs, is simply a consequence of abstinence. A person whose brain produces and transmits the proper amount of dopamine and serotonin will feel better, and any intervention by a faith healer, hypnotherapist or any other pseudoscientific practice, is simply a placebo. AAs believe in the placebo because their feelings of well-being correlates with their AA attendance. It is really no different of a mindset as with Native American tribes who once upon a time practiced “rain dances”, which were proven effective by their anecdotal experiences of seeing rain after these dance occurred. These people were not crazy, but were simply working out of ignorance of weather patterns. These dances may still be a part of Native American tradition, but they are no longer practiced for the purposes of actually producing rain. Why? Because the science is in, and we no know rain dances don’t work. That is what science does. It provides us with an improved understanding of things, so we can advance to the next step.
AAs do not, will not, discuss or educate its recruits on the science of addiction, and it will not update its practices to work in tandem with current scientific research. Regardless of what actual science shows, they hold true to the idea that their addictions are a consequence of moral weakness, for which the answer lies in moral re-armament. This is the nature of religion. The world is flat if the good book says it is flat, and nothing can be done to change this belief. A person in AA who fails, is believed to have failed because they did not work the program properly, not because of any physiological problem in their brain. The person who fails, and has been told over and over that “insanity is repeating the same thing over and over again, and expecting the same results,” is told to start once again at step one, regardless of how many times they may have failed before. Real treatment does not enter into the picture, and is more often than not discouraged if brought up to fellow AAs. Get right with God, and you’ll get right with your quit. This is the answer. the only answer. Science be damned.