Sunday, July 4, 2010

AA Stress Test

Alcoholics don't like to go to AA. Addicts don't like to go to AA. If alcohol and drugs were served free at AA, all alcoholics and addicts would like to go to AA. The only thing free at AA is sobriety, fellowship with alcoholics in recovery and the 12 step program of AA.
When people say that AA doesn't work, they're wrong. Often they're eventually dead wrong. Alcoholism and addiction are deadly diseases. AA works and millions have proven that with attendance at AA and working the 12 step program of AA they can have a life free of alcoholism and addiction.
Alcoholics and addicts don't like the company of other alcoholics and addicts early in recovery. They prefer innocent victims. Untreated Al Anon's are their favorite target. Alcoholism and Addiction bring out the worst in individuals. It's a disease of egotism, self centeredness and immaturity. As individuals progress in alcoholism and addiction they increasingly become psychopathic and sociopathic.
The Big Book of Alcoholics Anonymous states that the disease of alcoholism can be treated if one has 'rigorous honesty'. Alcoholism and addiction cause one to live a life of denial and lie first to oneself and then to others.
The trouble with Alcoholics Anonymous is that alcoholics in recovery don't accept the lies of other alcoholics. They've been there themselves and they know the game. They're not innocent victims. They don't accept the 'false promises' that alcoholics have been giving sometimes for years. They tell newcomers 'if you talk the talk, walk the walk'. They believe in ACTION. There's no 'into thinking' or 'into feeling' chapters in the Big Book, only action.
The only requirement for membership of Alcoholics Anonymous is a 'desire to stop drinking". The first step of Alcoholics Anonymous requires that one admits that they are 'powerless over alcohol.' All that means at it's simplest is that the alcoholic admits that they cannot predict with certainty what will happen after they take the first drink. A non alcoholic can say that they will never drink more than 2 or 3 drinks at most and never pass that line. A 'real' alcoholic may be able to do that sometimes but eventually they will binge and that binge, that drinking to state of impairment and drunkenness, will occur for the vast majority of alcoholics within 4 seasons or 1 year. Most will not be able to 'control' their drinking more than months at most.
AA is not a 'treatment' program per se. It's a spiritual program and a fellowship. It's common too for Alcoholics to tell a newcomer, 'do ninety meetings in ninety days' and if you don't like the result, 'we'll restore your misery'. Alcoholics Anonymous is a strictly voluntary program. A judge may say you can go to jail or AA or a doctor may say you can go to AA or die but no one really is 'forcing' you to go to AA. It's just that most people who go to AA know intuitively that they need to stop drinking or drugging and that AA is the best solution if not the only solution for long term sobriety.
A lot of alternative programs were set up following on the success of AA. They showed benefit for months and maybe years but few have shown the long lasting and almost universal proof that AA did. The living results of AA in fact changed the general clinical and social belief that alcoholism and addiction were untreatable diseases with characterological impairment, to the belief and hope that recovery is possible. Abstinence works.
Alcoholics hurt others, themselves and society. They fail through a wide variety of means. Mostly they under achieve and are negative. Alcohol and drugs are ultimately depressants. Alcoholics and addicts are depressing. They suck the life out of a room at times with their perpetual 'criticism' or their 'yes, but'. They lie and make promises and say that 'this time things will be different' but over and over again they fail and expect everyone around them to 'cut them some slack' and 'give them a second chance' or 'just lighten up'.
Alcoholics and addicts account for at least half the people in jails and asylums. That's how sick and 'bad' they are. The disease tells them it's alright to break the laws of society to serve their own selfish ends, their 'need' for alcohol or to be the 'big shot'.
When people who have been violent go to jail they usually don't want to go back. The reason is that the people they associate with in jail are violent like them. If they hit someone that person is likely to hit back and hit back harder. There are no easy victims.
AA is at first a 'stress test'. It's a place where alcoholics and addicts go to learn to be with other alcoholics and addicts. It's not surprising that 'group therapy' is the cornerstone of treatment of addiction. Rehab centers are predominantly living together places that focus on group therapy. Alcoholics and addicts have to learn to be social without using drugs or alcohol to cope with their emotions. The disease of alcoholism is a disease of emotional dyscontrol. Alcoholics have dealt with their experience of anxiety and anger in the social situation by drinking or drugging, isolating, lashing out or being 'drama queens' ie demanding undue attention.
Physical sobriety is the first step in the treatment of alcoholism. Alcoholics Anonymous teaches, "don't pick up the first drink'. Other related 12 step programs say 'don't pick up the first drug'. Learn to 'self soothe' in relationships without abusing drugs or alcohol or other dysfunctional behaviors.
Alcoholics Anonymous is a 'stress test' because alcoholics in recovery especially early in recovery are really almost impossible people. It takes tremendous patience and tolerance to listen to an alcoholic talk for even 5 minutes. They are commonly full of incongruence. What is so obvious to the person sitting across from the alcoholic or addict is utterly foreign to the alcoholic or addict. Invariably some alcoholic in a room of alcoholics will do something emotionally irritating or disturbing. There's the stress test. Here's the opportunity for a person in recovery to not get pissed off, not leave and never come back, not drink, not drug, not criticize and complain but rather just accept that's their 'disease'. The programs always stresses 'principles before personalities' though its also common for a number of people in AA just to parrot the slogans and sayings without really giving much thought to what they mean and or how they are supposed to be used daily in one's life.
The stress test is that alcoholics and addicts in denial simply don't like being on the receiving end of the kind of behaviours that their disease causes them to dish out. Other alcoholics will whine and snivel and dominate or ignore them and they won't find that their particular 'con' emotionally or otherwise usually 'flies'.
Alcoholics and addicts want to be among 'enablers'. They want to 'claim' they want to 'change' and they want to even 'contemplate' change but they don't want to to 'take action'.
Because so much 'waste' of health care funding was occurring with alcoholics and addicts, the greatest 'takers' of all, Prochaska and Miller developed a 'Stages of Change' to help clinicians devote their resources to alcoholics who are motivated rather than waste their resources on those who aren't. Alcoholics and addicts love counsellors who will listen to them ad nauseum and they'll even enjoy hearing over and over again a 'sales pitch' for sobriety. They're the best people for 'rescuers' to use to get massive amounts of funding to serve their own need to be 'rescuers'. But eventually they usually burn their bridges with the rescuers themselves because no one but the alcoholic or addict can stop the alcohlism or addiction. The trouble with 'rescuers' is that they commonly get addicts and alcoholics killed by playing into their delusions. They enable the alcoholic to regress to infancy by giving them the 'false milk'. Rescuers are self serving. The addict or alcoholic loves these 'marks' and will get sicker and sicker until even the 'rescuer' asks what are you willing to do and begins to treat the alcoholic or addict not as an infant but as another adult doing the classic 'tit for tat'. I give you this and you give me that. Good programs start at this most basic of social conditioning. They're real and real alcoholics and addicts respect those who are real.
It's interesting that this scientifically derived and supported approach to change developed by Miller and Prochaska for alcoholics is essentially the same process that individually has been the hallmark of 'old timers' approach to the alcoholics.
Old timers have sobriety and they're willing to tell a newcomer how to get it but they're quick to say 'carry the message' not the person.
The stress test of AA is that alcoholics learn to see themselves in the behaviours of other alcoholics and in sobriety grasp the basic rule of society : 'do unto others what you would have them do unto you' or 'don't do unto others what you don't want done unto you."
In Alcoholics Anonymous newcomers are encouraged to 'look at the similarities' and 'not the differences'. The reason for this is that alcoholics are 'terminally unique'. They think each and every one of them is a 'special case' and yet to the outside observer ,especially the trained clinician, they really are 'group of drunks' and they act so similarly as such and so differently from others. Mostly their emotional and cognitive functions are regressed or fixed at some adolescent level. That's why they're constantly having psychological 'emergencies' in recovery. It's also why they are such 'critics'. The adolescent is able to solve all the problems of the world at a distance but can't get a job or make their bed consistently. They further can't see the gross disconnect between their intellectual statements and their actions.
Once the first step of alcoholism is achieved, that is physical sobriety, the second step is emotional sobriety. Here one stops thinking predominantly about themselves and their needs such as whether they've got enough or have been hurt alot but rather just learning to 'act' like others. "Fake it till you make it," means to behave like normal people. Normal people do things like 'get jobs', 'pay the rent','do the laundry. 'return books', 'pay taxes', 'keep promises', 'show up on time', 'get to work early', 'do more than their share', 'work after hours', 'volunteer to help for free', 'don't expect pay for doing normal things', 'wait their turn', 'encourage others', 'help others', 'be of service', 'go to church', 'join community clubs', 'vote', 'join political parties', 'take part in a sport', 'be reliable'. In short, Alcoholism is not just a physical disease but an emotional, cognitive, psychological, and spiritual disease.
At the community level alcoholics have caused much damage by their 'contrariness'. They're commonly anti authority. They're like cars that arbitrarily decide to go against the flow of traffic and because they've made that decision and are now cursing all the other drivers coming at them they avoid getting hit but rarely see all the 'damage' around them.
Probably the principle reason that alcoholics leave AA after they get physically sober and get a year or two into the program is because the program increasingly tells alcoholics that they were the 'victimizer' and that they are the ones that now must make 'amends'. They have to give up seeing themselves as the 'victim'. Alcoholics have an uncanny capacity for shirking responsibility and once they are no longer drunk so can't use that as an excuse to miss work or show up late or not pay back loans or pull their own weight in society or care for strangers or contribute for free, they're find another excuse, be it whatever. Some say the disease of alcoholism is just a disease of 'self pity'. It's certainly a disease of egotism. Narcissism goes with immaturity and altruism with maturity.
So when alcoholics and addicts, life's greatest takers in disease get their needs met they move along and don't stay around to 'pay back'. Those who do, those who continue to go to meetings of AA long after they have sobered up when they have successful jobs, are caring for families, serve important roles in the community, are to the rest of society not seen as alcoholics, indeed are truly anonymous by the normalcy of their behaviour, these are the spiritually recovered members of AA.
The backbone of AA are these healthy normal members who once suffered from the disease of alcoholism but through practicing the steps of AA learned even how to tolerate and help other alcoholics and addicts. They recognise that they have a debt to society and they repay that debt by getting as many other alcoholics and addicts out of addictions as they are able. Mostly they stay sober themselves and become better people by stopping complaining, stopping whining, stopping bitching, stopping criticizing and instead pitching in and helping make the world a better place to live by their action and their example.
The stress test of AA is to be around other alcoholics and realize daily that what you don't like in them is what you don't see in yourself. So if you want to change them then you must first change yourself.
Ironically after an hour among alcoholics the rest of the world is pretty easy to tolerate. After an hour among alcoholics and seeing what idiots they can be any partially sane person will realize that they don't want to drink or drug as they'll end up like the worst person they met at the meeting If they stay sober and clean they just might become like that best person they met that night. In time they will become a contributing member of society again and if they remain in AA doing 'service' they will overcome the losses in personal development that came with their alcoholism and addiction.
The hard part though is remembering that the disease is 'cunning, baffling and powerful' and that the drinking and drugging part was just the tip of the ice berg. The real disease is spiritual and it shows itself at the level of fear and resentments, at anxiety and depression, at the level of isolation and alienation and the need to be the big shot or the baby, the drama queen or the one with a monopoly on suffering or insensitivity to the needs of others. Alcoholism and addiction are at their core ,diseases of 'taking' and 'bullying' 'playing the victim' and selfishness.
Recovery is about replacing 'vices' with 'virtues' and getting rid of character flaws, becoming adult members of community who are dependable, committed and contribute to the greater good. It's recognising that at a very critical time in life alcoholics and addicts were partying when everyone else was working. It's recognising that alcoholics and addicts 'partied' enough and now 'owe society' and have to make 'amends' to individuals and community. It's recognising that the 'suggestions' of AA are like the 'suggestions' on a parachute 'pull string to open shute'.
Recovery is not about avoiding stress, that's what alcoholism and addiction was about. Recovery is about facing stress. Courage isn't about avoiding danger but rather about overcoming fear in face of danger. The same is true about Recovery. It's about the stress test of being around other alcoholics, first those in recovery who while they don't drink still carry all the characterological flaws they acquired drinking, as well as eventually "helping the alcoholic who still suffers.' Recovery is about giving back. It's about helping other alcoholics because that is doing society a service. It's paying back for the misery the disease caused others.

The reason why people don't like AA is because it works. AA is a stress test. If an alcoholic or addict can succeed in AA they can take the learning they had there and move their rehabilitation to the higher level of community involvement not by denying their alcoholism but by both life long membership and committment to AA and by having a full and rewarding life of community involvement, work and family. The first thing AA gives to alcoholics and addicts , and what AA gave to society at large, was hope. AA showed that the disease of alcoholism and addiction could be 'cured' by abstinence. Abstinence is possible and abstinences works. So far nothing works better either. Alcoholics and addicts are forever looking for an 'easier softer way' but while there are countless of those .in the long run all the research continues to show that 'abstinence' and association with sober recovering community is what has the greatest success.

- Posted using BlogPress from my iPhone


bobbi said...

here here,,,,well put!

Aim said...
This comment has been removed by the author.
Aim said...

Very very informative. Your view that AA is indeed a "fellowship" rather than a "treatment" is a particularly interesting point. I used to think AA is like a confession room. May be I should attend some meetings to gain some experience.