So a Harvard doc is out there with a book to promote and, unfortunately for those of us who care about defending AA against uninformed attacks, it seems to be a direct hit on 12-step. (It would be hard to imagine that a book with the title The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry would be anything but.)
I have to assume that the author, Lance Dodes, is not trying to do harm. I would imagine that he’s attempting to help. And I have no doubt that there are hordes of people who are thrilled to have their angry claims endorsed by such an esteemed professional (the Orange Papers folks have surely cast the less credible Stanton Peele aside and declared Dodes their new hero).
Call It What You Want
But make no mistake. This book is a hit job, if the Salon excerpt is any indication and we have no reason to doubt that it is. We know it’s a hit job one paragraph in when it refers to the show Intervention in a dismissive aside: “The legions of ‘anonymous’ members who comprise these groups are helped in their proselytizing mission by TV shows such as Intervention (now canceled), which preaches the gospel of recovery,” says the piece. If a show that ran for 13 seasons and won an Emmy for Outstanding Reality Program is going to be mentioned only to imply that the once wondrous place AA held in our cultural landscape is perhaps waning, we already know we’re in less than unbiased territory.
So then we get to his assertion that “peer-reviewed studies peg the success rate of AA somewhere between 5 and 10 percent.” I should mention that I only heard about this percentage from no less an authority than Charlie Sheen, during his well-publicized meltdown that perhaps stood as AA’s best advertisement. Of course, anyone with awareness about the way AA works understands that there is no accurate way to get any success percentages; AA is an anonymous program that does not track the comings and goings of its members.
Areas of Expertise
The problem is that many doctors aren’t really familiar with AA at all. As NYU psychiatry professor Dr. Marc Galanter pointed out last summer, “Anyone treating people with any substance abuse problem should themselves have gone to some open AA meetings to get a better idea of what it is like. But fewer have had that experience than one would think relative to the benefits.”
Despite the numbers Sheen and his ilk toss around between marriages, there have been actual studies done on controlled groups of AA members that have indicated far different results. As clinical psychologist Joseph Nowinski wrote in the wake of Philip Seymour Hoffman’s death, studies show that “the more the individual identified him/herself as a recovering alcoholic (addict) the higher was his/her level of self-efficacy.” More results from that study: “Higher self-efficacy was associated with more months clean and/or sober” and “The more the individual leaned toward the recovering identity, the less likely she/he was to report having relapsed into drinking or drug use during the pervious two years.”
Do Your Research
All this being said, I understand why people are peeved at AA. Any program that says it’s our way or you’re going to end up dead or in jail or an institution is going to piss off anyone who tried it and didn’t respond. I personally know a few addicts who don’t do AA and seem to be living fruitful, productive lives. I don’t know the behind-the-scenes, of course, but there are other ways to find sobriety that clearly work. What I object to is people having a major forum to tackle something they don’t understand. I would never dream of going in and analyzing Dr. Dodes’ medical documents and sharing why I don’t think they make sense because I don’t have nearly enough knowledge about medicine to do such a thing. While Dodes has clearly thought about these matters—as opposed to, say, a writer who admits he’s never been to an AA meeting but writes a book decrying the organization nonetheless—I hardly think a program that saves millions of lives needs any more attacks. But since the attacks clearly aren’t going to stop anytime soon, can’t we at least have them be from people who understand what they’re talking about?