These Are Only Suggestions

By David B.

I like AA – especially the fellowship. In most locales, it’s the only show in town and the price is right.

When I was a kid, my family went to the Baptist church and my Baptist friends badmouthed Catholics. I married a Catholic and found out most Catholics were good people. Why did the Baptists think they were so bad? Catholics believed the wrong dogma (unchangeable beliefs). I ended up rejecting the dogmas from both groups and tend to believe that uncritically accepting any group’s dogma is fuzzy thinking. AA has a bit of dogma, despite Bill Wilson’s efforts to soften some of what’s in the Big Book: “We only know a little … future studies will show us new ways … these are only suggestions” … or some such language, talking about his book and the steps.

As opposed to dogma, the scientific method never claims to arrive at the absolute truth. The latest and best evidence is accepted for what it is – simply the latest and best evidence. The bottom line is subject to change whenever new evidence shows up. Dogma becomes kind of obsolete when you try to think like a scientist – and there are other questionable things about dogma.

suggestionbox2 Dogma has a tendency to be “all-or-nothing” about issues. So I understand, earthly phenomena, including most human behaviors, fall somewhere along a Bell-shaped curve. Things aren’t black or white nearly as often as they are various shades of gray. And there are multitudes of variables in epidemiological studies (such as alcoholism), making them notoriously difficult to interpret.

A couple of years ago, with the help of AA Agnostica, a group of us heathens in San Antonio started a secular AA group. At our meeting, for six minutes I can talk about whatever’s on my mind and nobody interrupts me. After everyone’s had their turn (usually a real treat to listen to), we might have a bit of cross talk before reciting the Responsibility Pledge. Some of us like the steps and some don’t. Some of us have had sponsors and some haven’t. One of us wears a t-shirt that says, “Science doesn’t care what you believe.” Only a few of us are the least bit religious and we have good discussions and fellowship.

I like some of the AA slogans – for example, “Don’t drink, no matter what”, “Don’t take yourself so seriously”, “It’s a 24-hour program”, “I may not be much but I’m all I think about”, and my favorite, “Take what you like and leave the rest.” Other AA slogans, I don’t like – for example, “Let go and let god” – and any others advocating simplistic reliance on ghosts.

Just an example of how AA dogma doesn’t follow current scientific literature is a commonplace AA belief about recovery. A couple of weeks ago after a meeting, a disagreement surfaced about the likelihood of spontaneous remission from alcoholism. The discussion that ensued is what prompted me to write this article. One of my buds (Sam) thought recovery without treatment was extremely rare and unlikely – an opinion many AAs would agree with. Others of us had read the literature and believed untreated recovery to be commonplace. Sam spent hours the next week researching articles about the subject and the scientific papers behind the articles. As a result of his study, he changed his mind. The following week, he showed me an article that he thought represented the best and most current knowledge: “Recovery from DSM-IV Alcohol Dependence” – Dawson, et al.

I read it – like trudging through a morass of statistical swampland in hip-boots. Ten or so pages of excruciating, hairsplitting detail including four lengthy tables. More information than I signed up for but I got the point. Here are a few of their conclusions, summarized better than I could have by Maia Szalavitz with the Pacific Standard.

Contrary to popular belief, most people recover from their addictions without any treatment — regardless of whether the drug involved is alcohol, crack, methamphetamine, heroin, or cigarettes. One of the largest studies of recovery ever conducted (the Dawson study) found that, of those who had qualified for a diagnosis of alcoholism in the past year, only 25 percent still met the criteria for the disorder a year later. Despite this 75 percent recovery rate, only a quarter had gotten any type of help, including AA, and as many were now drinking in a low-risk manner as were abstinent.

Unfortunately, compared to the rehab narrative, the stories of people who get better without treatment are rarely as compelling. They tend to consist of people leaving college and realizing they can’t binge drink or take drugs and hold a job and care for a family. And since most people who straighten out on their own never show up in treatment, the worst cases congregate in rehab and make addiction recovery seem quite rare.

—Maia Szalavitz, “After 75 Years of Alcoholics Anonymous It’s Time to Admit We Have a Problem”, The Pacific Standard, February 10, 2014

There is room for argument about these conclusions (epidemiological studies being difficult to interpret). And you may have noticed the subtle debunking of another sensitive item – that some people who’ve been diagnosed with DSM-IV can learn to drink socially. We could throw in whether alcoholism qualifies as disease – but I’m not interested in arguing any of those things (although I have limits – it’s not an allergy). My point is, I don’t buy all of AA’s dogma but I still like AA. Despite its flaws, it’s a remarkable organization that serves people around the world. I believe many people who don’t “keep coming back” still benefit from their experience with AA, including, at times, varying degrees of recovery. And that those who continue to go to meetings profit from their participation whether or not they follow the common tenets of AA.

take-what-you-needThere are some who have joined our secular group for only a couple of weeks to several months, but then left, never to be seen again. I choose to believe our brief fellowship did them some good. Hopefully, some came to grips with their drinking problem and moved on with their lives. I’m also pretty sure some didn’t (come to grips). But they probably didn’t all immediately spiral into oblivion simply because they weren’t going to meetings.

Most attendees at our meetings don’t like the (sometimes overwhelming) religiosity at regular meetings and many don’t like various aspects of AA dogma. The good news is, you can believe whatever you want and still be a valuable member. The only requirement for participation is a desire to stop drinking and you’re a member if you say you are. You truly can “Take what you like and leave the rest”. Those who insist you do your program their way may not like it when you don’t (do their program), but you don’t have to change your program, harbor a resentment, or even take them seriously.

My catchphrase might be, “It’s the fellowship, stupid” – no insult intended. Not only can I talk about my latest efforts on becoming a better human but I get to hear others in my group do the same. It’s the best game in town.

Audio Version 

Audio narrated by Len R., Jasper, GA 


About the Author, David B. 

Dave B. is also the author of  “A New Agnostic AA group and a Hat Tip to Unitarians”, published in  AA Agnostica  on March 15, 2015.  He is a physician who is pleased and proud to have been sober now for twenty-six months.  He achieved nonbeliever status during his senior year at an ultra-religious college. Since then, he claims, “the longer I live, the more it looks like nobody’s watching.”  His home group is Mostly Agnostics AA of San Antonio – check out their website at  Mostly Agnostics AA.  He and his Catholic wife have six kids, all married and productive, for which he is grateful.  He takes as much credit for their success as his wife will let him.

 

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Galen T
Galen T

Thanks very much for your article, David.  It well illustrates the difficulty of making any categorical statements about alcoholics, even ones based on research.  The study described by Maia Zzalavitz, for example, raises more questions that it resolves.  For starters, on what basis were the persons under study diagnosed  as alcoholics?  Many studies, not to speak of many opinions about alcoholics, are complicated by unclear distinctions between heavy drinkers and the true alcoholic. This is the case even with the raised bar to which Bill W. refers in the Big Book.  Of course there is no way to draw a… Read more »

Peter T.

“AA is not an abstinence enforcement organization but a program of recovery” – if I may… AA is a fellowship (see the rest of the preamble) and AA HAS a suggested program.  The “AA IS a program” thinking is what fuels the dogma, and a misunderstanding widely accepted at face value.  I’m sure you didn’t mean otherwise, but I find I need to be very careful with the language here, when trying to explain my point of view to the zealots.  Thanks for taking the time to put together your comments.

Dave B

Thanks to you folks who took the time to respond – your comments were better than my essay.  And thanks for the clever visual aids, Doris.

Victoria
Victoria

May I add that I do love Beyond Belief and Agnostica precisely because it feels like a safe middle ground for me. The Middle Way, if you like, between the sometimes rabid / fevered anger of the various leaving / left / can’t stand AA sites, and the equally rabid / fevered evangelistic dogmatism of AA-Under-The-Influence of back-to-basics and its offshoots.

So, thank you, BB and Ag.

Victoria
Victoria

Great piece, David, thanks so much. I’ve been cogitating a great deal on all the matters raised by you, your sources and of course respondents here in (my very calming space of) AA Beyond Belief (and Agnostica). Being Australian, there are virtually no (that’s almost zero) meetings like you guys have – as I always mention, there’s ONE here in my city Melbourne, but I can’t easily get to it. So, I just beaver away on my own research  and work in multiple ways on my massive problem with alcohol addiction with a dual diagnosis of mental health probs plus… Read more »

life-j
life-j

Victoria, have you ever looked into Naltrexone/Nalmefene as medications to stop or cut back to safe levels of drinking? I wrote an article both here and at aaagnostica about it. One of the doctors at the convention told me that for some the side effects are more problematic than often mentioned, but anyway, have a look.

life-j
life-j

Dave you were right, I do like this article (and good to meet you!).  Though valid objections can be raised to almost anything and everything (including the objections) we do need to start coming out of the trenches that AA has dug for itself. I think a lot of hardcore AA people people are scared, and with good reason that once we start critisizing one part of the program the whole house of cards is going to come down, and AA will fall apart so they choose to insist that every bit of it is right, instead. And it could… Read more »