thought i might do a little rap on 12-step programs.

now first off, let me say that i got sober in aa in 1990, stayed sober until 2003 or so, relapsed for a few years, and then got sober without aa (sobriety date 1.1.08). aa got my dad off booze in the last years of his life, and na got my brother jim off heroin/cocaine. no program could help my brother adam, who died of an overdose while out from rehab for a court date.

there is one reason above all that the 12-step model is compelling: it was designed by alcoholics: people who actually knew from inside what addiction is, not doctors or priests or public health officials. every page of the aa "big book" comes from the actual experience of addiction from the inside. and the power of aa, of course, derives largely from the fact that the people in it share this experience.

aa is an amazing organization, for one thing a kind of model of anarchist organization. it has no leaders and no hierarchy. anyone can start an aa group, and "the only requirement for membership is a desire to stop drinking."

the first step - "admitted we were powerless over alcohol and that our lives had become unmanageable" - is actually what allowed me to stop. it is a fundamental 12-step insight that the addict suffers not from too little but from too much willpower, or "self-will run riot." "i can stop anytime i want" is a lie in the service of death; admit you can't stop, just let go, and stopping becomes possible. this is a great paradox, but it is the only thing i've actually seen work. this is also a profound, let's say spiritual insight: letting the world or yourself be is the way to transform it or you.

aa promotes a very dogmatic "disease" model of addiction. at one point the big book refers to alcoholism as an "allergy." this is important for several reasons; it's a treatment for the overwhelming burden of shame which arises from and keeps you drinking. that is, i think the result is more strategic than medical.

the disease model seems, for one thing, to deny personal responsibility for decisions etc, or to deny the role of free will. this, again, is an important strategic moment and connected to "powerlessness," but actually much aa teaching is in direct tension with it. in the twelve steps, taking responsibility is the fulcrum, as in "made a list of all persons we had harmed and became willing to make amends to them all"; "made direct amends to such people wherever possible," etc. you wouldn't take a cancer survivor and tell him that to get better he has to make amends to everyone whom his cancerous condition has harmed. i think the disease model is interesting but inadequate, even from within the aa orientation, but try saying that in an aa meeting.

the question of moral responsibility and free will in addiction, i think, could make philosophers among others think harder about these issues. it is a tremendously complex matter. you can't force yourself to be sober if you're an addict by a sheer choice. on the other hand, without a sense of the moral significance, you wouldn't be trying, basically, and you want to reach a point where you can take responsibility fully even for actions that do not proceed precisely from free decisions. this, briefly, should be used to re-theorize the "free will problem."

the "spiritual dimension of the program" is of course a problem for an atheist like me. the aa conception is wide open, and your higher power can be anything but yourself. it also forms a way of describing the release moment, where you get out of the cycle of forcing yourself to not use, and then using anyway: let go and let god, as they say. and like the theme of service to others, it is a way to try to get the addict out of a narcissistic entrapedness in the self that is the most truly torturous part of addiction.

some aa groups are more open than others, however, and i'd be lying if i didn't say the very-christian orientation of groups i've been in in alabama and central pa wasn't offputting at times. other groups are far more mellow, including those i first got into in nashville. but the religious barrier can be overcome, and any decent aa group is pretty non-dogmatic about any religious orientation or doctrine, which is what the big book teaches.

on the other hand, aa does descend into very rigid doctrine, as in the unquestioning assertion of the disease model ("i'm not a bad person trying to get good; i'm a sick person trying to get well"). what keeps me away from aa meetings as much as anything is sheer repetition: let go and let god; one day at a time: i'm not sure i can even hear these things any more; i've heard them tens of thousands of times. they help, and the repetition helps, especially for "the newcomer," for whom it is best to "keep it simple." on the other hand, my god, and i'd like to go deeper. and a series of slogans is not, by itself, a way of life.

Comments

[sober house]

Interesting book,the "big book" i like to buy this its very informative,i also agree that people who actually knew from inside what addiction is, not doctors or priests or public health officials. keep posting!

cletsey

[Strike]

Bateson has a good piece on this in Steps to An Ecology of Mind.

[marriotr]

It would be interesting, perhaps, to at some point consider how an organization as decentralized as AA might degenerate, limit, and corrupt itself, as all societies of mankind do. The religiosity you mentioned might be one means to such an end.

[Andrew Dobbs]

It's awesome that you say all of this. I've lived with AA people--my uncle and mother--and my grandmother is really into al-anon and for a long time I've regarded it as an anarchist kind of experiment. In terms of "bossism" I'd say AA does a lot better than most consciously anarchist movements. The 12 Traditions need to be looked at, the whole project as a model for revolutionary change--whether spiritual or political.

[judith]

"the question of moral responsibility and free will in addiction"

Please write a book on this, Crispin! It would be brilliant.

[1littlewho]

why?

[stillnotking]

I think the contradictions in AA doctrine stem from our fundamental misunderstanding of what concepts like "choice" and "responsibility" actually mean. In the West, philosophers typically approach this question from the free-will-versus-fatalism angle, a false dichotomy if ever there was one. Eastern thinkers have delved more deeply (a book I highly recommend is Hubert Benoit's [i]Zen and the Psychology of Transformation[/i], which makes a pretty strong effort to explain Eastern ideas in Western terms).