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Old 6th July 2019, 01:24 PM   #241
Thor 2
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Originally Posted by Minoosh View Post
Because the conversation keeps changing. Yes, I do perceive that if one objection is addressed another will rush in, but they're not all coming from you.

What I'd like to know is, why did you find the secular 12 steps "wishy-washy" and "meaningless"? Can you be more specific? Do you have suggestions for improvement? What if there was a group that had applied those steps to their own lives, and could help others do the same?

Well the following 3 mainly seem wishy washy to me - the coloured ones are the Godless ones. Don't know how to prove or measure wishy washiness, just a sense that the author is desperately trying to make something fit.


5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
Admitted to ourselves without reservation, and to another human being the exact nature of our wrongs.
6. Were entirely ready to have God remove all these defects of character.
Were ready to accept help in letting go of all our defects of character.
7. Humbly asked Him to remove our shortcomings.
With humility and openness sought to eliminate our shortcomings.
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Old 6th July 2019, 02:35 PM   #242
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Originally Posted by whoanellie View Post
If AA stands for anything, it is that alcoholism is not simply a "moral failure".


I'm going to quote from the Gabrielle Glaser article in The Atlantic that is critical of AA:
"As an organization, Alcoholics Anonymous has no real central authority—each AA meeting functions more or less autonomously—and it declines to take positions on issues beyond the scope of the 12 steps. (When I asked to speak with someone from the General Service Office, AA’s administrative headquarters, regarding AA’s stance on other treatment methods, I received an e-mail stating: “Alcoholics Anonymous neither endorses nor opposes other approaches, and we cooperate widely with the medical profession.” The office also declined to comment on whether AA’s efficacy has been proved.)"

Imagine if AA did conduct or fund studies of its effectiveness? Would you trust those studies. Couldn't it be argued that those studies were biased? To those who attend AA meetings, the proof of its success is their own sobriety and that of those around them.
If they are well designed and transparent, why not? But, as you say, AA is ethereal, each meeting is something different. It is a social club.

To people that attend church, the benefit they derive is proof of it's validity;
Ditto people that go to Chiropractors, homeopathy, etc.
One person's faith does not truth make.

AA's 12 steps were handed down like the 10 commandments. There is no reason or science involved. Debating the 12 steps is debating religion. It's all Hitchen's razor. The 12 steps where handed down without evidence and they can be dismissed without it.

Peer support has science behind it as helpful. The 12 steps add nothing of benefit to peer support.

You weren't reasoned into your faith, reason won't disabuse you of it.

ETA: Forgot to address "moral failure". Tell me what other disease requires a "spiritual awakening" to fix? Right, only moral failure requires spiritual awakening. Religion is not the solution to disease. And, again, AA is a religion with the Big Book as the Bible and Bill W as the prophet. Nothing has changed in 80 years, which again, is a hallmark of a religion.
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Old 6th July 2019, 02:54 PM   #243
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Originally Posted by isissxn View Post
But there are tons of secular alternatives. They're just not as well-known because they haven't been around as long.

Furthermore, there's no reason that the programs couldn't be tweaked to remove the most overt religiosity, especially in inpatient settings. It is so detrimental to recovery to force an atheist who is already at the end of their rope to recite the Lord's Prayer (for example) at the end of every group meeting like a child at religious boarding school. Not everyone will appreciate that because not everyone ******* hates religion with a passion, but many of the people committed to rehab DO.

They already lose so many of their rights by virtue of being in there, then it's just like an extra kick in the face. Especially when places lie about it. "Oh no, no religion here!" Then the people get there, and they're locked in, and they're not allowed to make phone calls for at least a week, and oh whaddaya know? Prayer time, every day, multiple times a day. Don't like it? We'll tell the judge you were being uncooperative.

Everyone has their berserk buttons, and this is one of mine. I see it as extremely shady and disrespectful, and it was the main reason I quit my old job (at that particular kind of center). That is where my objection comes from, and like I said, I'm completely intractable about it. Courts need to update their list of options.
Sad fact: The court goes through the motions. It has no true vested interest in "curing" anyone's addictions.

12 step programs for individuals convicted of alcohol or drug possession related convictions is nothing more than ticket punching.

The jurisdictions that have gone to the "drug court" model

https://www.nij.gov/topics/courts/dr...s/welcome.aspx

Do a somewhat better job of it, but everything related to successfully getting clean rides on the individual, not the program.
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Old 6th July 2019, 03:35 PM   #244
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Originally Posted by Darat View Post
As I said above unfortunately AA is not being treated by the state as a drop-in social club for drunks, it is being treated by the state as if it was a treatment for alcoholism, which you and its other proponents in this thread also claim.

Problem is that such claims are not evidence based.
I make no argument that the state should be mandating AA and arguably, in the USA, there are 1st amendment issues when courts do so. I believe that courts and employers adopted the practice of mandating AA because there was no more effective or cost-effective alternative. As BStrong notes, there has been a move towards "drug courts" recently. I understand that "drug court" programs include AA as a option.

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Old 6th July 2019, 04:59 PM   #245
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Originally Posted by Darat View Post
As I said above unfortunately AA is not being treated by the state as a drop-in social club for drunks, it is being treated by the state as if it was a treatment for alcoholism, which you and its other proponents in this thread also claim.

Problem is that such claims are not evidence based.
We're treating it like it's treatment? We shouldn't be. AA is not medical treatment. But peer support might be a legitimate part of an overall treatment plan, even if one can't standardize the peer-support experience.
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Old 6th July 2019, 05:20 PM   #246
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Originally Posted by Thor 2 View Post
Well the following 3 mainly seem wishy washy to me - the coloured ones are the Godless ones. Don't know how to prove or measure wishy washiness, just a sense that the author is desperately trying to make something fit.


5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
Admitted to ourselves without reservation, and to another human being the exact nature of our wrongs.
6. Were entirely ready to have God remove all these defects of character.
Were ready to accept help in letting go of all our defects of character.
7. Humbly asked Him to remove our shortcomings.
With humility and openness sought to eliminate our shortcomings.

Aside from the absence of a deity I see no real qualitative difference between any of these comparisons.

Is it the god-bothering that makes the religion based ones less wishy-washy to you?
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Old 6th July 2019, 09:56 PM   #247
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Originally Posted by Thor 2 View Post
Well the following 3 mainly seem wishy washy to me - the coloured ones are the Godless ones. Don't know how to prove or measure wishy washiness, just a sense that the author is desperately trying to make something fit.


5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
Admitted to ourselves without reservation, and to another human being the exact nature of our wrongs.
6. Were entirely ready to have God remove all these defects of character.
Were ready to accept help in letting go of all our defects of character.
7. Humbly asked Him to remove our shortcomings.
With humility and openness sought to eliminate our shortcomings.
Hmm, kind of clunky. It's not difficult to rewrite 6, but 7 is tricky. Still, I bet there's a way.

About 15 years after the Big Book was published Bill Wilson recreated this early version of the Six Steps:


Admitted hopeless
Got Honest with self
Got honest with another
Made Amends
Helped other without demand
Prayed to God as you understand Him

AA is not going to rewrite the steps anytime soon, but this does show the process can be expressed differently.

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Old 7th July 2019, 03:57 PM   #248
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Originally Posted by Darat View Post
And the major problem is that apparently there are no standards that one can assume all AA meets follow. Therefore you can't compare different AA meets as they are all likely to be different to one another.
Originally Posted by The Greater Fool View Post
The 12 steps are statement of faith. Alcoholism is a moral failure that requires a spiritual awakening. How is that NOT religion?
If that's a real question, here's something that addresses things that both you and Darat say:

To me the 12 steps are statements of commitment, not faith. The spiritual awakening could just as easily be called emotional growth. The process of self-examination and amends is designed to clear up toxic grudges and shame. You see how you've contributed to your own troubles, but you also see that a lot of stuff isn't your fault.

Darat is right that there isn't any way to standardize the steps; there isn't even a requirement that you do them. There haven't always been 12 of them. But they hit the same areas.

The steps don't really tell you how to stop, though. A few people may be struck sober; obviously most are not. A lot of effort has gone into creating some standardized formula that makes people ready to quit, and I'm not sure it's possible. Bill Wilson eventually felt that LSD might help people get there. For someone, somewhere, it probably did.
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Old 7th July 2019, 05:12 PM   #249
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Originally Posted by Minoosh View Post
AA is not medical treatment.
There is zero evidence that AA helps and lots that it doesn't. It seems that your chance of quitting alcohol with AA is the same as if you never went to a meeting.

Quote:
But peer support might be a legitimate part of an overall treatment plan, even if one can't standardize the peer-support experience.
What part of the program is good for an overall treatment program? The part where you sit in a room and listen to other alcoholics glorify their drinking days and refer to new people as "light weights" who don't know the meaning of "rock bottom?"
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Old 7th July 2019, 05:25 PM   #250
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Originally Posted by Minoosh View Post
To me the 12 steps are statements of commitment, not faith. The spiritual awakening could just as easily be called emotional growth. The process of self-examination and amends is designed to clear up toxic grudges and shame. You see how you've contributed to your own troubles, but you also see that a lot of stuff isn't your fault.
So the problem with alcoholics is that they aren't spiritually woke enough?

You are twisting the meaning of all things AA in an attempt to make it fit what is currently known about addiction. One of the big issues with AA is that they are stuck in the past, touting a system that doesn't work because it is in their best interest to do so. If they were truly interested in a cure their program would have evolved since its inception.

Early addiction therapy was based on a very flawed set of experiments on rats and we have been paying for it ever since. Rats were put in a cage and given a choice between water and water laced with drugs. They inevitably chose the drugs.

However, there was a serious flaw. The rats were in a cage. Nothing else. Take that same cage and put things in there for rats to do, other rats for them to socialise, and have sex, with and the rats inevitably ignored the drugs in favour of plain water.

Take from that what you will but it definitely shows that sitting around a barren room, smoking cigarettes and drinking coffee while talking about the glory days of drinking, isn't a good strategy for recovery.
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Old 7th July 2019, 05:32 PM   #251
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Originally Posted by qayak View Post
Take from that what you will but it definitely shows that sitting around a barren room, smoking cigarettes and drinking coffee while talking about the glory days of drinking, isn't a good strategy for recovery.
I can barely remember smoking meetings. Today they're probably illegal.

ETA:

Originally Posted by qayak View Post
There is zero evidence that AA helps and lots that it doesn't. It seems that your chance of quitting alcohol with AA is the same as if you never went to a meeting.
"It seems"? That's some rigorous language right there.

Read the links.

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Old 7th July 2019, 06:55 PM   #252
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I've read every link presented in this thread.

I've read how AA, when grouped in with peer support AFTER in or out patient treatment yields positive results.

I've read the 'orange papers' that 'seem' to make good points.

Bottom line, AA is a religion. Like any religion, if it works for you: Hallelujah! Praise the Lord! Spread the word (Step 12).
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Old 7th July 2019, 07:07 PM   #253
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Originally Posted by qayak View Post
There is zero evidence that AA helps and lots that it doesn't. It seems that your chance of quitting alcohol with AA is the same as if you never went to a meeting.




This is false.
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Old 7th July 2019, 08:24 PM   #254
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Originally Posted by The Greater Fool View Post
I've read every link presented in this thread.

I've read how AA, when grouped in with peer support AFTER in or out patient treatment yields positive results.

I've read the 'orange papers' that 'seem' to make good points.

Bottom line, AA is a religion. Like any religion, if it works for you: Hallelujah! Praise the Lord! Spread the word (Step 12).
They won't knock on your door and try give you pamphlets. AA will hook you up with someone to talk to if you ask for it. And plenty of its members do it fine without supernatural beliefs.

I don't know how big it is but there is an agnostic AA movement.
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Old 7th July 2019, 10:03 PM   #255
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More from the rat park guy, Bruce Alexander.

Quote:
Global society is drowning in addiction to drug use and a thousand other habits. This is because people around the world, rich and poor alike, are being torn from the close ties to family, culture, and traditional spirituality that constituted the normal fabric of life in pre-modern times.
There's that word "spirituality." I'm not totally sure you can reason yourself into good mental health. You can try. I think he's right about building community, and he does not seem to be setting himself in opposition to AA.
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Old 8th July 2019, 01:32 AM   #256
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Originally Posted by qayak View Post
Take that same cage and put things in there for rats to do, other rats for them to socialise, and have sex, with and the rats inevitably ignored the drugs in favour of plain water.

Take from that what you will but it definitely shows that sitting around a barren room, smoking cigarettes and drinking coffee while talking about the glory days of drinking, isn't a good strategy for recovery.
Not that your description of an AA meeting is correct, but that's quite a leap isn't it?
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Old 8th July 2019, 03:29 AM   #257
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Originally Posted by whoanellie View Post
This is false.
In terms of what you can say about AA it is true, because you can't extrapolate from one AA meet to another. So a particular meet may provide evidence that it helps better than no treatment but that is all. You have no way of knowing why that particular meet in that particular time frame had a better than no treatment success rate.

As defined by you and others in this thread there is no evidence that any particular AA meet is better than no treatment. In other words there is no evidence that AA meets (note the plural) have a better success rate than no treatment.
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Old 8th July 2019, 04:46 AM   #258
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Originally Posted by Darat View Post
In terms of what you can say about AA it is true, because you can't extrapolate from one AA meet to another. So a particular meet may provide evidence that it helps better than no treatment but that is all. You have no way of knowing why that particular meet in that particular time frame had a better than no treatment success rate.

As defined by you and others in this thread there is no evidence that any particular AA meet is better than no treatment. In other words there is no evidence that AA meets (note the plural) have a better success rate than no treatment.
A VA studied a sample of 2,319 male alcoholics in 15 Veterans Administration inpatient programs. It wasn't just one meeting. But you could argue that relying only on inpatient programs for veterans does not extrapolate to a representative cross-section of community meetings.

Project MATCH, a different large study, had perhaps a bigger flaw: There was no control group.

You're right about about the potential pitfalls - AFAIK no one has studied meeting-by-meeting success rates. But for all their variability they do tend to rely on a fairly similar template. Steps, meetings, sharing stories: What it was like, what happened and what is it like now. So it's not a free-for-all, either.
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Old 8th July 2019, 05:46 AM   #259
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Originally Posted by Minoosh View Post
They won't knock on your door and try give you pamphlets. AA will hook you up with someone to talk to if you ask for it. And plenty of its members do it fine without supernatural beliefs.

I don't know how big it is but there is an agnostic AA movement.
Have you noticed that of several points that people raise, you pick one to address? Like the point that no treatment for any disease is spiritual awakening.

No, AA won't knock on your door. Most religions don't. Like AA, they remain religions no matter how circumspect they are about evangelism.

You know there are religions without god? They are still religions. Agnostic AA is still a religion.

When any aspect of AA is challenged, you twist and mold AA to explain how that aspect is not required:

- Step 12 in not 'in your face' evangelism, so it's not as bad as other religions;

- You can remove 'god' from the 12 steps.

- Every meeting is different, so there is no one AA. However, studies show peer support, including AA, can be beneficial so score 1 for AA.

- The list goes on and on;

There is nothing about AA that you aren't willing to explain away to make it palatable. Except that religion thing, that's one thing AA isn't.

You completely missed the 'Orange Papers', oops.
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Old 8th July 2019, 06:24 AM   #260
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Originally Posted by whoanellie View Post
Exactly. Whether you agree with AA methods/philosophy/spirituality or not, it has helped a lot of people recover from a miserable condition.
Not statistically, it hasn't.
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Old 8th July 2019, 06:42 AM   #261
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Originally Posted by Minoosh View Post
A VA studied a sample of 2,319 male alcoholics in 15 Veterans Administration inpatient programs. It wasn't just one meeting. But you could argue that relying only on inpatient programs for veterans does not extrapolate to a representative cross-section of community meetings.



Project MATCH, a different large study, had perhaps a bigger flaw: There was no control group.



You're right about about the potential pitfalls - AFAIK no one has studied meeting-by-meeting success rates. But for all their variability they do tend to rely on a fairly similar template. Steps, meetings, sharing stories: What it was like, what happened and what is it like now. So it's not a free-for-all, either.
I do understand you have found your AA meets useful but you can't have it both ways, either there are standards applied and enforced in all AA meets or there isn't. You seem pretty adament there aren't so the success you believe you have had via your AA meets can not be used as an indicator that AA meets help people.

And don't forget the reason for this thread, someone was/is being forced to attend a meet that has religious elements when they do not have such beliefs. I also introduced the concern I have in regards to a state forcing someone into treatments that are not evidence based.

From your and others statements about what AA is my concerns have been heightened, I had assumed there was *an* AA treatment/approach I didn't realise there are no standards, that there is no consistent approach that could even in principle be subjected to actual scientific review.

There seems to be no grounds by which anyone can recommend from actual evidence any AA meets as a way to reduce or stop alcohol consumption, or as a treatment for alcoholism or even a support group for alcoholics.

I'm now 100% of the view that no state should be forcing anyone to attend any AA meet.
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Old 8th July 2019, 09:17 AM   #262
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Originally Posted by isissxn View Post
I think he's referring to addicts who have a physical dependence. Alcohol withdrawal, if the dependence is serious enough, can be fatal. In those kinds of cases, ceasing drinking isn't enough. Medical intervention (usually including hospitalization) is needed.

Of course, once the detox is complete, everything comes down to coping mechanisms.
Most certainly, I have known two people who died from alcohol withdrawl
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Old 8th July 2019, 09:25 AM   #263
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just for contrast here is rational recovery (Trimpey himself is a jerk in many ways, but the program is reasonable)
https://rational.org/index.php?id=1
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Old 8th July 2019, 11:32 AM   #264
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Originally Posted by Belz... View Post
Not statistically, it hasn't.
Is that the only valid criterion available to us?
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Old 8th July 2019, 12:03 PM   #265
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Originally Posted by whoanellie View Post
Is that the only valid criterion available to us?
Yes, actually.
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Old 8th July 2019, 02:03 PM   #266
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Originally Posted by quadraginta View Post
Aside from the absence of a deity I see no real qualitative difference between any of these comparisons.

Is it the god-bothering that makes the religion based ones less wishy-washy to you?

I wouldn't call he God based steps wishy washy as they are firmly focused on the God theme. If you believe in God it all makes sense in a way. Even though I don't have that belief I can see that.
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Old 8th July 2019, 03:02 PM   #267
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State mandated AA gives a wily drunk a way out in a year, without actually having to bother going sober full time.

Get your licence back, keep your job and all for testing clean and not being stupid for about a year. You can learn the structure of the program and have a few barley pops at key times, just not near : surprise ' urine tests. If you play well they even claim you as a success for the program.

I know because several friends had to do it.

Going in fighting when the law says you must attend rehab hurt one bad financially and he actually had to sober up for 3 years.

Or one could actually want to stop being a drunk and then most anything would work. That us what I wanted before stupidity caught up with me.

It's all in the motivation of the person.
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Old 8th July 2019, 03:50 PM   #268
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AA is an addiction.
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Old 8th July 2019, 04:18 PM   #269
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Originally Posted by The Greater Fool View Post
Have you noticed that of several points that people raise, you pick one to address?
Yes, I'm trying to address things people say without posting some huge essay responding to everything.

Originally Posted by The Greater Fool View Post
Like the point that no treatment for any disease is spiritual awakening.
If you think spirituality plays no role in healing, OK. The Rat Park guy does cite spirituality and suggests the "fix" is making connections and building community. That's what AA is, but there are other communities and more yet that can be built.

Originally Posted by The Greater Fool View Post
You know there are religions without god? They are still religions. Agnostic AA is still a religion.
How? By being a community that agrees on shared values?

Originally Posted by The Greater Fool View Post
When any aspect of AA is challenged, you twist and mold AA to explain how that aspect is not required:
Because the only requirement for membership is a desire to stop drinking.

Originally Posted by The Greater Fool View Post
- Step 12 in not 'in your face' evangelism, so it's not as bad as other religions;
At this point I don't even know what you mean by "religion."

Originally Posted by The Greater Fool View Post
- You can remove 'god' from the 12 steps.
IMO, you can. Not everyone in AA agrees, but we disagree about a lot of things.

Originally Posted by The Greater Fool View Post
- Every meeting is different, so there is no one AA. However, studies show peer support, including AA, can be beneficial so score 1 for AA.
OK.

Originally Posted by The Greater Fool View Post
There is nothing about AA that you aren't willing to explain away to make it palatable. Except that religion thing, that's one thing AA isn't.
I can only speak for my experience.

Originally Posted by The Greater Fool View Post
You completely missed the 'Orange Papers', oops.
What makes you think I missed it? I've quoted from it, in this thread:

Originally Posted by Agent Orange
"There is no shortage of insane doctors, mad scientists, and other sick "therapists" who love to torture their patient-prisoners with fascist medicine."
He quit drinking after a doctor warned him once. That's cool. BTW he thinks peer support is BS, even detrimental. He suggests having the right spouse.

Trying to counter him point by point - is madness for me. Can't do it.

If people want to form a community around hating AA that's cool. I hope it works for them.
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Old 8th July 2019, 04:21 PM   #270
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Originally Posted by 8enotto View Post
Or one could actually want to stop being a drunk and then most anything would work. That us what I wanted before stupidity caught up with me.

It's all in the motivation of the person.
True. How to get motivated before your life blows up in your face - that's not an exact science.
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Old 8th July 2019, 04:52 PM   #271
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Originally Posted by Darat View Post
In terms of what you can say about AA it is true, because you can't extrapolate from one AA meet to another. So a particular meet may provide evidence that it helps better than no treatment but that is all. You have no way of knowing why that particular meet in that particular time frame had a better than no treatment success rate.

As defined by you and others in this thread there is no evidence that any particular AA meet is better than no treatment. In other words there is no evidence that AA meets (note the plural) have a better success rate than no treatment.
Assuming for the moment your argument is valid, isn't it valid both ways? How can there be evidence that any particular AA meeting doesn't help? How then can qayak's statement, "There is zero evidence that AA helps and lots that it doesn't.", be true?

There is some variability in AA meetings across both time and space, as there is in just about any human endeavor. That random variability, fluctuations, noise, whatever you want to call it is precisely what statisticians deal with on a regular basis and in no way precludes asking the question "Does AA have a positive impact on some measure of success for admitted alcoholics?" Pollsters ask people who they are going to vote for in an upcoming election. They can't extrapolate from their data to determine how Edgar in Des Moines will vote, but they can analyze their data statistically to predict who will win an upcoming election. I've said it before, AA is notoriously difficult to study for a variety of different reasons. Some of them have been discussed above. Pollsters determine how many people they have to poll to get the desired margin of error . I suspect that there are techniques that would allow a statistician to determine the sample size necessary to determine the effectiveness of AA across a given city, country, or the world. There are other aspects of the experimental design and data collection that would present far bigger challenges.

I'm going to quote from the article by Kaskutas that both Minoosh and I have linked to above.
"Criterion 1, strength of association How large is the relationship between AA exposure and abstinence? As shown in Figure 1, which draws on a longitudinal study of male inpatients in Veterans Administration programs, rates of abstinence are about twice as high for those who attended a 12-step group such as AA following treatment. One-year follow-ups considered 12-step group attendance and abstinence from alcohol and drugs, while the 18-month results reported AA attendance and alcohol abstinence. Results are remarkably similar, at 1-year and 18 months, for these different exposure and abstinence measures. About 20%–25% of those who did not attend AA or another 12-step group (or receive any other form of aftercare after the inpatient stay) were abstinent from alcohol and drugs at 1 year [15], and from alcohol at 18 months (combined alcohol and drug abstinence were not reported at 18 months) [16]. The rates of abstinence were about twice as high among those who had attended AA or another 12-step group (but no other form of aftercare). In terms of effect sizes, this translates to a robust medium-size effect (h=.5) [17, pp. 181–p.185]. Other studies are available that report on other substance use measures (such as percent days abstinent/PDA) and samples. This study is selected to demonstrate the strength of the association because it comes from a large sample (n=3018 at 1 year), it reported simple dichotomous measures of AA or 12-step group exposure and abstinence, and it reported separately for those who attended AA/12-step groups during follow-up but were not exposed to subsequent formal treatment."

That's evidence, actually statistical evidence, of AA's effectiveness. You may find the evidence weak, you may debates the merits of the experimental design, etc., etc., but it is evidence. The quote does refer to "Veterans Administration programs". If I get a chance I'll look at the original work to see how many different locations the study included. By the way, people are allowed to go to as many different meetings as they choose to find ones that work for them. So one person's sobriety doesn't depend on the effectiveness of 1 meeting.

Not all questions require answers based on statistics. If you ask me do lots of people like chocolate ice cream I would say yes. Do I have statistical evidence to back that up, no, but I'm quite confident that a lot of people like chocolate ice cream. How can i say that, after all there are different brands of chocolate ice cream? Yes, there are variations amongst different brands of chocolate ice cream but in the end lots of people like something that they consider to be chocolate ice cream. If you ask me has AA helped a lot of people then I would respond yes. Statistics, we don't need no stinking statistics.

It is not my intention to argue that courts/employers should force anyone to go to AA. There are valid arguments to be made against such mandates. However, I firmly believe that arguments that it is established that AA is not helpful to anyone or even harmful are both incorrect and are themselves potentially harmful.

Last edited by whoanellie; 8th July 2019 at 05:04 PM. Reason: add last paragraph
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Old 8th July 2019, 07:53 PM   #272
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Originally Posted by whoanellie View Post
Is that the only valid criterion available to us?
To individuals making life choices? No. To society making public policy choices? Yes.
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Old 8th July 2019, 09:12 PM   #273
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Originally Posted by Darat View Post
In terms of what you can say about AA it is true, because you can't extrapolate from one AA meet to another. So a particular meet may provide evidence that it helps better than no treatment but that is all. You have no way of knowing why that particular meet in that particular time frame had a better than no treatment success rate.

As defined by you and others in this thread there is no evidence that any particular AA meet is better than no treatment. In other words there is no evidence that AA meets (note the plural) have a better success rate than no treatment.
There is no evidence to support this. AA used to claim that they had a 100% success rate. That was proven wrong. Then they claimed a lesser amount. That was proven wrong based on the numbers they quoted. A study of their claimed numbers showed they had no better success than not going to AA.

Since their claims were debunked AA has steadfastly refused to provide any statistics on the claim that it is an invasion of privacy and threatens people's anonymity. For an organization that has no statistics on success there are sure a lot of people here making claims like they have actual statistics.

The known success rate of AA is exactly that of people who do not attend AA. 5-10%. Alcoholism tends to run its course and AA has no impact on that. The issue with AA is that it harms the other 90-95%. They tout the success and blame the failure on the addict. iI you are one of the unsuccessful ones you have failed, the program didn't fail you. The program never fails. It is blasphemous to suggest that the programmed failed someone. They failed, not the program.

Every other treatment program sees relapse as a failure of the treatment but not AA. They see it as a failure of the patient.
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Old 8th July 2019, 09:46 PM   #274
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Originally Posted by whoanellie View Post
Not all questions require answers based on statistics. If you ask me do lots of people like chocolate ice cream I would say yes. Do I have statistical evidence to back that up, no, but I'm quite confident that a lot of people like chocolate ice cream. How can i say that, after all there are different brands of chocolate ice cream? Yes, there are variations amongst different brands of chocolate ice cream but in the end lots of people like something that they consider to be chocolate ice cream. If you ask me has AA helped a lot of people then I would respond yes. Statistics, we don't need no stinking statistics.
The difference is that people can't fool themselves into thinking they like chocolate ice cream. Liking chocolate ice cream is not subject to the cognitive biases that can fool people into thinking a medical treatment has been effective when it hasn't. That's why we do need to use the scientific method when assessing medical treatments, even though we don't need to use it when finding out the most popular flavours of ice cream.
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Old 9th July 2019, 06:14 AM   #275
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Originally Posted by Minoosh View Post
Yes, I'm trying to address things people say without posting some huge essay responding to everything.

If you think spirituality plays no role in healing, OK. The Rat Park guy does cite spirituality and suggests the "fix" is making connections and building community. That's what AA is, but there are other communities and more yet that can be built.

How? By being a community that agrees on shared values?

Because the only requirement for membership is a desire to stop drinking.

At this point I don't even know what you mean by "religion."

IMO, you can. Not everyone in AA agrees, but we disagree about a lot of things.

OK.

I can only speak for my experience.

What makes you think I missed it? I've quoted from it, in this thread:



He quit drinking after a doctor warned him once. That's cool. BTW he thinks peer support is BS, even detrimental. He suggests having the right spouse.

Trying to counter him point by point - is madness for me. Can't do it.

If people want to form a community around hating AA that's cool. I hope it works for them.
Every argument you have made a Catholic could equally make, but it doesn't make Catholicism not a religion.

I wonder if there is such a thing as culturally AA. Not unlike a cultural Christian or Jew. Dogma isn't important, it's about community. Not the worst way to live.

At any rate, enjoy your community. I actually am glad that you are happy and healthier.
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Old 9th July 2019, 06:30 AM   #276
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Originally Posted by whoanellie View Post
Assuming for the moment your argument is valid, isn't it valid both ways? How can there be evidence that any particular AA meeting doesn't help? How then can qayak's statement, "There is zero evidence that AA helps and lots that it doesn't.", be true?

There is some variability in AA meetings across both time and space, as there is in just about any human endeavor. That random variability, fluctuations, noise, whatever you want to call it is precisely what statisticians deal with on a regular basis and in no way precludes asking the question "Does AA have a positive impact on some measure of success for admitted alcoholics?" Pollsters ask people who they are going to vote for in an upcoming election. They can't extrapolate from their data to determine how Edgar in Des Moines will vote, but they can analyze their data statistically to predict who will win an upcoming election. I've said it before, AA is notoriously difficult to study for a variety of different reasons. Some of them have been discussed above. Pollsters determine how many people they have to poll to get the desired margin of error . I suspect that there are techniques that would allow a statistician to determine the sample size necessary to determine the effectiveness of AA across a given city, country, or the world. There are other aspects of the experimental design and data collection that would present far bigger challenges.

I'm going to quote from the article by Kaskutas that both Minoosh and I have linked to above.
"Criterion 1, strength of association How large is the relationship between AA exposure and abstinence? As shown in Figure 1, which draws on a longitudinal study of male inpatients in Veterans Administration programs, rates of abstinence are about twice as high for those who attended a 12-step group such as AA following treatment. One-year follow-ups considered 12-step group attendance and abstinence from alcohol and drugs, while the 18-month results reported AA attendance and alcohol abstinence. Results are remarkably similar, at 1-year and 18 months, for these different exposure and abstinence measures. About 20%–25% of those who did not attend AA or another 12-step group (or receive any other form of aftercare after the inpatient stay) were abstinent from alcohol and drugs at 1 year [15], and from alcohol at 18 months (combined alcohol and drug abstinence were not reported at 18 months) [16]. The rates of abstinence were about twice as high among those who had attended AA or another 12-step group (but no other form of aftercare). In terms of effect sizes, this translates to a robust medium-size effect (h=.5) [17, pp. 181–p.185]. Other studies are available that report on other substance use measures (such as percent days abstinent/PDA) and samples. This study is selected to demonstrate the strength of the association because it comes from a large sample (n=3018 at 1 year), it reported simple dichotomous measures of AA or 12-step group exposure and abstinence, and it reported separately for those who attended AA/12-step groups during follow-up but were not exposed to subsequent formal treatment."

That's evidence, actually statistical evidence, of AA's effectiveness. You may find the evidence weak, you may debates the merits of the experimental design, etc., etc., but it is evidence. The quote does refer to "Veterans Administration programs". If I get a chance I'll look at the original work to see how many different locations the study included. By the way, people are allowed to go to as many different meetings as they choose to find ones that work for them. So one person's sobriety doesn't depend on the effectiveness of 1 meeting.

Not all questions require answers based on statistics. If you ask me do lots of people like chocolate ice cream I would say yes. Do I have statistical evidence to back that up, no, but I'm quite confident that a lot of people like chocolate ice cream. How can i say that, after all there are different brands of chocolate ice cream? Yes, there are variations amongst different brands of chocolate ice cream but in the end lots of people like something that they consider to be chocolate ice cream. If you ask me has AA helped a lot of people then I would respond yes. Statistics, we don't need no stinking statistics.

It is not my intention to argue that courts/employers should force anyone to go to AA. There are valid arguments to be made against such mandates. However, I firmly believe that arguments that it is established that AA is not helpful to anyone or even harmful are both incorrect and are themselves potentially harmful.
You say every AA is different and thus studies can't capture anything meaningful, then quote a study that AA is benefical. You admit the conflict here, but then go on to extrapolate AA's benefits.

Let me extrapolate differently:

First, this is after an in/out patient treatment program, which should be noted. AA meetings are a support feature, not a central feature.

Second, if every AA is different, it seems to me that the study is measuring the aspect common to all AA meetings: Peer support.

Like you, Dogma isn't as important as peer support / community. It's not about the 12 steps, which you admit aren't important. Which, now that I think back, the 12 steps did not feature in any of the meeting I attended, just experiences.

So, peer support has demonstrated benefit. Occams razor and all that.
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Old 9th July 2019, 07:43 AM   #277
whoanellie
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Originally Posted by Pixel42 View Post
The difference is that people can't fool themselves into thinking they like chocolate ice cream. Liking chocolate ice cream is not subject to the cognitive biases that can fool people into thinking a medical treatment has been effective when it hasn't. That's why we do need to use the scientific method when assessing medical treatments, even though we don't need to use it when finding out the most popular flavours of ice cream.
Do you think people can fool themselves into thinking they are sober?
AA is not a medical treatment.
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Old 9th July 2019, 07:48 AM   #278
Dave Rogers
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Originally Posted by whoanellie View Post
Do you think people can fool themselves into thinking they are sober?
Is that a serious question? Every drunk driver thinks s/he's sober enough to drive a car, and is fooling him/herself. And plenty of high functioning alcoholics are able to fool themselves into thinking they're not dependent on alcohol.

Originally Posted by whoanellie View Post
AA is not a medical treatment.
It doesn't seem like "AA" can be defined as anything, really; yet courts are mandating it. What do they think they're mandating?

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Old 9th July 2019, 07:57 AM   #279
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Originally Posted by whoanellie View Post
Do you think people can fool themselves into thinking they are sober?
I think people can fool themselves into thinking attending AA meetings is the reason they have managed to stay sober, just as they can fool themselves into thinking a homeopathic remedy they took is the reason they're feeling better.
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Old 9th July 2019, 08:23 AM   #280
whoanellie
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Originally Posted by Dave Rogers View Post
Is that a serious question?

Dave
Absolutely
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