Hacker Newsnew | past | comments | ask | show | jobs | submitlogin

The vocabulary of AA is unfortunate. It has a historical underpinning (AA is essentially a single-purpose offshoot of an oddball "first century Christianity" feel-good movement) and it is incredibly difficult to find a way clear of the "AA cult" within AA. While I don't like it, I can (to a limited extent) understand it - people who have recovered are highly reluctant to mess with the program as they understand it.

That said, there are a lot of us atheists (and, of course, people whose religious/spiritual beliefs, if they have them, are incompatible with the ever-present whiff of Christianity ) who have managed to recover in AA. The steps (with one exception, explained later) can be divorced from the idea of the supernatural, and actually boil down to an effective cognitive/behavioural therapy. (They have been re-written many times, but because of frictions with mainstream AA, it's difficult to find the secularized versions published anywhere outside of the agnostic/atheist groups.) The only fly in the ointment, I suppose, would be the fifth step, which requires one to posit an all-knowing entity. It doesn't require believing that one exists; it's more a recognition that trying to hide things from yourself, to rationalise things that aren't rational, or to take on more blame or responsibility than you honestly ought to own is futile and counterproductive.

There are more than a handful of us working to fix this. I wish I could say the battle is an easy one. Frankly, one gets a little tired of hearing (after nearly thirty years sober) that if I don't get God, I'll get drunk - from people who are still riding the pink cloud. If one looks hard enough, one can find rational people and groups in AA; one day, they may even be listed with the other groups (as we generally were until just a few years ago). I'm going to put on my optimist hat in the meantime and read the big push-back as the death throes of something whose time has passed.



>can be divorced from the idea of the supernatural, and actually boil down to an effective cognitive/behavioural therapy.

So lets stop it with all the mumbo jumbo crap and go to real CBT.


The one part of AA that can't be simply transferred to a professional therapeutic setting is the peer support. There is absolutely no substitute for a large enough number of people who've been there, done that and puked on enough T-shirts that a sizable handful can tell you your very own story (with the dates, times and names altered somewhat). Learning how to live after the drinking (or other addictive behaviour) goes away is hage as well, and it's an ongoing process that takes years. Most "treatments" only take you to the point of feeling better, and it is far too easy to mistake feeling better for being well.

As I said in my previous, there are a whole bunch of us working on getting rid of the "mumbo jumbo", but we're unwilling to throw the baby out with the bath water. Those of us who've been around for long enough have seen the difference between merely quitting and a sustainable lifestyle change often enough to understand that merely removing the self-medicating behaviour is asking for a lifetime of the symptoms one was attempting to medicate. That is not enough for anyone. We've also seen how long it takes to go from black and white through various bit levels of greyscale to a full life of colour and nuance - the whole damned universe changes suddenly on a regular basis for about the first five or six years.

The problem I've seen with alternative efforts is that they either concentrate on a "quick cure" (a short-term effort that is supposed to take you through a lifetime, but winds up being about as effective in practice as leaving AA behind the moment you think you've got a handle on things) or treat the substance abuse as a separate concern from the rest of life. The problem tends to be that for some value of "better", life is better for the drunk on the other side of the bottle cap than it is on this side. That's what needs to change, and that's what a rational approach to AA provides.


>The one part of AA that can't be simply transferred to a professional therapeutic setting is the peer support.

Have you ever been to CBT or DBT? I have (not for addiction, for psychiatric illness). It is specially and absolutely practiced in a group setting, with peer support. There is also a one-to-one part too, with a professional. I was in inpatient hospitalization, outpatient hospitalization, and less intensive treatment.

>Most "treatments" only take you to the point of feeling better.

Wrong wrong, couldn't possibly be more wrong. I have personal experience, as I've said. Stop it with the scare quotes around treatment.

>treat the substance abuse as a separate concern from the rest of life.

This absolutely positively does not happen in a clinical setting. I've been in "behavioral health" treatment (which includes addiction) for many years. There have been addicts in my CBT/DBT groups. People don't stop getting help unless they want to stop. If they need more CBT, they stay. If they need it again, they will start it again. If they need to see a therapist (one that specializes in addiction mind you) more often then they are, they do. Treatment is entirely up to what the patient wants and needs. Nobody progresses at the same pace.




Guidelines | FAQ | Lists | API | Security | Legal | Apply to YC | Contact

Search: