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I can't speak for all of AA obviously but I've been heavily involved in it for decades now. This is definitely one of those "all models are wrong but some model

I can't speak for all of AA obviously but I've been heavily involved in it for decades now. This is definitely one of those "all models are wrong but some models are useful" situations with the allergy thing. Most individuals either find that model sufficiently useful that they don't need to expand it. Or, they're more or less fully aware of the gaps but still find that model useful. Or they don't find it useful and quietly use another model personally. All kinds of approaches in there. If we're talking about 'the real world' then "It is never safe for you to begin drinking again, in any context" is a highly conservative and risk-averse approach, but it has been valuable for so many, and the consequences of relapse can be so high. AA is full of people who "went back out there" after 2, 5, 10+ years of sobriety because they thought they could reintroduce it into their lives and were wrong. Also many stories of people who did and just straight died in the relapse. Often our support networks can't handle another round, plus kindling is a real thing. AA is where I first heard about van der Kolk's research, which demonstrates very convincingly that in some very real ways there's not a meaningful difference between "biological" and "psychological" components of trauma or addiction. The AA framework has some incredible faults don't get me wrong. But above all those people are intensely, almost pathologically sometimes focused on "the real world." You'll hear some weird shit coming out of there sometimes because of that, but it doesn't mean they're not aware of the contradictions, or unwilling to apply more "scientific" models. Just, they have a system that works for a lot of people so they keep it going.

photochemsyn 5y ago
Are you saying that AA promotes discredited scientific claims because of a belief among their members that such claims have utility in helping their members quit drinking and stay off alcohol? Why even have the quasi-scientific patina then? Just go back to purely religious-era thinking, things like 'You'll burn in hell for all eternity if you don't get off the booze right now". The problem with groups like AA is that they seem incapable of revising their dogmatic beliefs when presented with new evidence. What if opiate addiction and alcohol addiction are not 'lifelong diseases' at all, but simply treatable conditions? Would AA revise its claims if presented with such evidence?
- giraffe_lady 5y ago
  Yeah that's exactly what I'm saying. And if the burn-in-hell model was demonstrably more effective than a medical model I would endorse it. Wouldn't you? What's the value in pushing a scientific model if it isn't actually more practically effective at helping the people who are asking for help? And look, I'm not saying the medical model isn't more effective. But "new evidence" isn't always easy to apply even when it is clear, and with addiction it very often is not. AA's method despite its serious serious flaws has worked for a lot of people over many decades, so yes there is some natural conservatism about updating it every decade to keep up with new research. You're on the right track though with the dogma thing. If you're familiar with the sociological study of religions, looking at it through that lens can be very valuable. It has a cultus of belief and ritual, it has a community of believers, and yes a dogma. It doesn't never change, but it is slow to. To understand this thing you need to try to understand what value it has to people. If you want them to switch to another approach you need to demonstrate the actual practical value of that approach to people. This is literally life and death shit, people aren't going to part with it just because some le atheist engineers don't like that they call it an allergy and ask god for help.
  - photochemsyn 5y ago
    What I object to is religious types trying to use bad science to back up their agenda. Science is not a matter of faith, and it's a complete perversion of the basic concept of scientific inquiry to promote false claims simply because of their claimed utility. That's a dishonest and manipulative strategy at best, and I doubt any good will come of it. Of course, science provides no ultimate answers of the type religious fundamentalists (a group which includes the dogmatic atheist IMO) seem to be seeking. For example, it's impossible to use science to test the 'simulation hypothesis', i.e. the notion that we're all living in a perfect VR sim.
    - giraffe_lady 5y ago
      Well, in this case "their agenda" is helping people out of deep addiction. What do you gain by opposing that? We aren't disinterested third parties here pushing an agenda on other people, this is US, working for ourselves. Who are you? Expecting people to abandon a belief that they can plausibly claim has saved their life because it isn't scientifically true is a radical ideology. Very much good has come from it, true or not. If you think you can do better then pick up a shovel man, and get to work. Because one of the other things AA provides is practical advice on how to work with people you don't understand or like, towards the shared goal of healing and sobriety.
gitfan86 5y ago
I really appreciate your response and respect your experience. I'm very happy for people that have been able to make positive changes in their lives and I'm not suggesting anyone stop doing AA if it works for them. It would be great if there was a sister organization to AA that was more of a group therapy session, without the spirituality and alcohol abstinence components. But maybe that wouldn't work, since there would be no rules and groups could diverge toward unhealthy behaviors.
- giraffe_lady 5y ago
  There's one called Smart Recovery that is more along those lines. They put a lot of effort into keeping their practice in line with the state of the art of mainstream mental health and scientific practice around addiction, and are explicitly secular. They're based around harm reduction, so no day-counting or rigid definition of sobriety like AA which honestly is wonderful and AA could (and does!) learn a lot from it. Alcoholics already carry a lot of shame, increasing it isn't helpful imo. It doesn't have the reach or widespread cultural awareness that AA does but they still seem pretty common. I think AA is only really a good fit for people who are already religious or are open to becoming so. Otherwise I generally do suggest people try smart recovery first.
- xanaxagoras 5y ago
  There's all kinds of stuff like that. They don't help. The only sober people at those types of things either use it as an adjunct to their 12 step program or aren't actually alcoholic.
zafka 5y ago
Great post! I have been a long term member myself, and you described my feelings about AA pretty well. It was fun to read what Charlie Munger ( Warren Buffet's partner) wrote about AA. He says that AA uses a number of natural psychological tendencies together to create a "Lollapalooza effect" that helps people to stay stopped, once they quit drinking.

photochemsyn 5y ago

Are you saying that AA promotes discredited scientific claims because of a belief among their members that such claims have utility in helping their members quit drinking and stay off alcohol? Why even have the quasi-scientific patina then? Just go back to purely religious-era thinking, things like 'You'll burn in hell for all eternity if you don't get off the booze right now". The problem with groups like AA is that they seem incapable of revising their dogmatic beliefs when presented with new evidence. What if opiate addiction and alcohol addiction are not 'lifelong diseases' at all, but simply treatable conditions? Would AA revise its claims if presented with such evidence?

giraffe_lady 5y ago
Yeah that's exactly what I'm saying. And if the burn-in-hell model was demonstrably more effective than a medical model I would endorse it. Wouldn't you? What's the value in pushing a scientific model if it isn't actually more practically effective at helping the people who are asking for help? And look, I'm not saying the medical model isn't more effective. But "new evidence" isn't always easy to apply even when it is clear, and with addiction it very often is not. AA's method despite its serious serious flaws has worked for a lot of people over many decades, so yes there is some natural conservatism about updating it every decade to keep up with new research. You're on the right track though with the dogma thing. If you're familiar with the sociological study of religions, looking at it through that lens can be very valuable. It has a cultus of belief and ritual, it has a community of believers, and yes a dogma. It doesn't never change, but it is slow to. To understand this thing you need to try to understand what value it has to people. If you want them to switch to another approach you need to demonstrate the actual practical value of that approach to people. This is literally life and death shit, people aren't going to part with it just because some le atheist engineers don't like that they call it an allergy and ask god for help.
- photochemsyn 5y ago
  What I object to is religious types trying to use bad science to back up their agenda. Science is not a matter of faith, and it's a complete perversion of the basic concept of scientific inquiry to promote false claims simply because of their claimed utility. That's a dishonest and manipulative strategy at best, and I doubt any good will come of it. Of course, science provides no ultimate answers of the type religious fundamentalists (a group which includes the dogmatic atheist IMO) seem to be seeking. For example, it's impossible to use science to test the 'simulation hypothesis', i.e. the notion that we're all living in a perfect VR sim.
  - giraffe_lady 5y ago
    Well, in this case "their agenda" is helping people out of deep addiction. What do you gain by opposing that? We aren't disinterested third parties here pushing an agenda on other people, this is US, working for ourselves. Who are you? Expecting people to abandon a belief that they can plausibly claim has saved their life because it isn't scientifically true is a radical ideology. Very much good has come from it, true or not. If you think you can do better then pick up a shovel man, and get to work. Because one of the other things AA provides is practical advice on how to work with people you don't understand or like, towards the shared goal of healing and sobriety.

gitfan86 5y ago

I really appreciate your response and respect your experience. I'm very happy for people that have been able to make positive changes in their lives and I'm not suggesting anyone stop doing AA if it works for them. It would be great if there was a sister organization to AA that was more of a group therapy session, without the spirituality and alcohol abstinence components. But maybe that wouldn't work, since there would be no rules and groups could diverge toward unhealthy behaviors.

giraffe_lady 5y ago
There's one called Smart Recovery that is more along those lines. They put a lot of effort into keeping their practice in line with the state of the art of mainstream mental health and scientific practice around addiction, and are explicitly secular. They're based around harm reduction, so no day-counting or rigid definition of sobriety like AA which honestly is wonderful and AA could (and does!) learn a lot from it. Alcoholics already carry a lot of shame, increasing it isn't helpful imo. It doesn't have the reach or widespread cultural awareness that AA does but they still seem pretty common. I think AA is only really a good fit for people who are already religious or are open to becoming so. Otherwise I generally do suggest people try smart recovery first.
xanaxagoras 5y ago
There's all kinds of stuff like that. They don't help. The only sober people at those types of things either use it as an adjunct to their 12 step program or aren't actually alcoholic.

zafka 5y ago

Great post! I have been a long term member myself, and you described my feelings about AA pretty well. It was fun to read what Charlie Munger ( Warren Buffet's partner) wrote about AA. He says that AA uses a number of natural psychological tendencies together to create a "Lollapalooza effect" that helps people to stay stopped, once they quit drinking.