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> The reason I hesitate to dismiss the AA view is that it strikes me as quite possible that, for a subset of addicts, any kind of hope of moderation can be disa

> The reason I hesitate to dismiss the AA view is that it strikes me as quite possible that, for a subset of addicts, any kind of hope of moderation can be disastrous. This, absolutely this. And since it is impossible to know in advance if moderation is possible for a given person, AA optimizes for the worst case scenario and assumes that no one can handle moderation, which has the greatest likelihood of success for all who use this strategy.

jwdunne 8y ago
Although different substance, I'm a heavy smoker and moderation has always proved impossible. I've kicked the habit once by NRT and once cold turkey. I'd gone well long enough for any physical withdrawal symptoms (many months). Both times, I thought just one wouldn't hurt, socially. Both times I started right back up again. There was a time I could smoke socially. I know people who did that and then went on to live a smoke free life. On the flip side, I've known smokers go years without and just one "oh go on then" hooked them right back on it. So if nicotine addiction is anything to go by, it would be possible in other addictions too. Unfortunately, the only alcoholics I knew lost their battle and never achieved any semblance of sobriety. They were both at a point where the withdrawal would kill them without clinical supervision.
Frondo 8y ago
AA isn't so much a recovery program as a submarine Christian conversion program; it's seldom better than nothing, and often worse. Very consistently and well-marketed, though. https://www.theatlantic.com/magazine/archive/2015/04/the-irrationality-of-alcoholics-anonymous/386255/ https://www.theatlantic.com/magazine/archive/2015/04/the-irr... (Fun fact: when it started, it wasn't anonymous -- except one of the founders kept showing up drunk in public, and they realized this itself was pretty quickly debunking their success claims!)
- hellofunk 8y ago
  I think this is a rather unfair distortion of AA. I know many who have been tremendously helped by the program. It does work for many. It's explicitly unreligious -- they have a notion of a higher power, but make the conscious effort to allow each member to have their own definition of this higher power. It's not a religious process in the sense most would think of it. I also don't think it's fair to mention any one particular person's success or lack thereof with AA when making sweeping generalizations about the program (including the founder, which I don't know if what you say is actually correct or not -- it just doesn't matter). The other important thing that AA does, which is quite critical, is get individuals with problems frequent, implicit counseling from others who have been through the same thing. This is very hard to get in modern life in most other ways. It's possible, but AA makes it the default process. You can throw away all the other stuff about AA and dismiss it, and you are still left with the fact social therapy in any form is very effective, and AA promotes that.
  - coldtea 8y ago
    >It's explicitly unreligious -- they have a notion of a higher power, but make the conscious effort to allow each member to have their own definition of this higher power. Very magnanimous of them. But why would a rehabilitation program have a notion "of a higher power", and especially it's own notion of it?
    - Someguywhatever 8y ago
      Probably because it helps people? If it is useful in helping people to not harm themselves and others then I don't see anything wrong with that.
      - leetcrew 8y ago
        > If it is useful in helping people to not harm themselves and others this is a big if. the way AA is structured (they don't themselves collect any statistics about efficacy whatsoever) makes it extremely difficult to draw any conclusions about how helpful it is. as other people have said, AA essentially provides free group therapy, which is likely to be at least slightly helpful. i'm not sure there's any evidence to suggest that the 12 steps or higher power aspect yield any benefits over generic group drug counseling.
        petyrbaelish 8y ago
        There is some evidence that the higher power business works[1]. Anyway, it will always be difficult to directly judge a particular organization rather than its methods. [1] The Power of Habit, by Charles Duhigg : while not scientifically spotless, the book directly addresses the methods of AA. To successfully establish a change in habit, one needs a belief that I can change : there is some sound evidence presented in the book. Smart Change, by Art Marckman : he is literally a scientist and I can't find anything scientifically incorrect in this book. He also mentions and gives evidence for the advantage of belief in one's ability to change : here the context is not directly AA.
  - Frondo 8y ago
- ionised 8y ago
  As someone who attended AA meetings for a few months when my depression/anxiety/substance abuse was getting out of control I have to agree with this. A couple of the chapters were fine, and listening to people tell stories of their experiences was great, but there is a heavy cult-like vibe pushed on you relentlessly at most. They parrot on about the fact that you are helpless to effect change in your own life and without the group, you will inevitably drink again. That turned me off completely and I never went back. Still haven't had a drink in a year since either.
dfee 8y ago
Not necessarily. The AA model is then unforgiving. This can create tremendous pressure, with the consequences of non-compliance being infinitely greater. When it works, it works the best. When it doesn’t work, it’s a cliff. E.g. “20 years out the window”.

jwdunne 8y ago

Although different substance, I'm a heavy smoker and moderation has always proved impossible. I've kicked the habit once by NRT and once cold turkey. I'd gone well long enough for any physical withdrawal symptoms (many months). Both times, I thought just one wouldn't hurt, socially. Both times I started right back up again. There was a time I could smoke socially. I know people who did that and then went on to live a smoke free life. On the flip side, I've known smokers go years without and just one "oh go on then" hooked them right back on it. So if nicotine addiction is anything to go by, it would be possible in other addictions too. Unfortunately, the only alcoholics I knew lost their battle and never achieved any semblance of sobriety. They were both at a point where the withdrawal would kill them without clinical supervision.

Frondo 8y ago

AA isn't so much a recovery program as a submarine Christian conversion program; it's seldom better than nothing, and often worse. Very consistently and well-marketed, though. https://www.theatlantic.com/magazine/archive/2015/04/the-irrationality-of-alcoholics-anonymous/386255/ https://www.theatlantic.com/magazine/archive/2015/04/the-irr... (Fun fact: when it started, it wasn't anonymous -- except one of the founders kept showing up drunk in public, and they realized this itself was pretty quickly debunking their success claims!)

hellofunk 8y ago
I think this is a rather unfair distortion of AA. I know many who have been tremendously helped by the program. It does work for many. It's explicitly unreligious -- they have a notion of a higher power, but make the conscious effort to allow each member to have their own definition of this higher power. It's not a religious process in the sense most would think of it. I also don't think it's fair to mention any one particular person's success or lack thereof with AA when making sweeping generalizations about the program (including the founder, which I don't know if what you say is actually correct or not -- it just doesn't matter). The other important thing that AA does, which is quite critical, is get individuals with problems frequent, implicit counseling from others who have been through the same thing. This is very hard to get in modern life in most other ways. It's possible, but AA makes it the default process. You can throw away all the other stuff about AA and dismiss it, and you are still left with the fact social therapy in any form is very effective, and AA promotes that.
- coldtea 8y ago
  >It's explicitly unreligious -- they have a notion of a higher power, but make the conscious effort to allow each member to have their own definition of this higher power. Very magnanimous of them. But why would a rehabilitation program have a notion "of a higher power", and especially it's own notion of it?
  - Someguywhatever 8y ago
    Probably because it helps people? If it is useful in helping people to not harm themselves and others then I don't see anything wrong with that.
    - leetcrew 8y ago
      > If it is useful in helping people to not harm themselves and others this is a big if. the way AA is structured (they don't themselves collect any statistics about efficacy whatsoever) makes it extremely difficult to draw any conclusions about how helpful it is. as other people have said, AA essentially provides free group therapy, which is likely to be at least slightly helpful. i'm not sure there's any evidence to suggest that the 12 steps or higher power aspect yield any benefits over generic group drug counseling.
      - petyrbaelish 8y ago
        There is some evidence that the higher power business works[1]. Anyway, it will always be difficult to directly judge a particular organization rather than its methods. [1] The Power of Habit, by Charles Duhigg : while not scientifically spotless, the book directly addresses the methods of AA. To successfully establish a change in habit, one needs a belief that I can change : there is some sound evidence presented in the book. Smart Change, by Art Marckman : he is literally a scientist and I can't find anything scientifically incorrect in this book. He also mentions and gives evidence for the advantage of belief in one's ability to change : here the context is not directly AA.
- Frondo 8y ago
ionised 8y ago
As someone who attended AA meetings for a few months when my depression/anxiety/substance abuse was getting out of control I have to agree with this. A couple of the chapters were fine, and listening to people tell stories of their experiences was great, but there is a heavy cult-like vibe pushed on you relentlessly at most. They parrot on about the fact that you are helpless to effect change in your own life and without the group, you will inevitably drink again. That turned me off completely and I never went back. Still haven't had a drink in a year since either.

dfee 8y ago

Not necessarily. The AA model is then unforgiving. This can create tremendous pressure, with the consequences of non-compliance being infinitely greater. When it works, it works the best. When it doesn’t work, it’s a cliff. E.g. “20 years out the window”.