Wednesday, April 28, 2010

Is Alcoholics Anonymous a Religion or Not?

Monday's blog about Alcoholics Anonymous brought quite a vigorous response from AA's defenders. The blog discussed scientific studies that show that attending AA makes people less likely to recover than if they got no treatment at all, and many readers were apparently offended by this.

The discussion reminded me yet again why I think religion is bad for society as a whole. It teaches that faith trumps reality, and convinces people that if they want something to be true, it must be true.

On the one hand, you have people trained in the sciences who work hard to remove their biases so that they can find the truth even if it is disagreeable. They've developed techniques that make it hard to fool themselves, such as randomly assigning people to one treatment or another, "double blind" studies where those evaluating the outcome don't know which person was assigned to which treatment, and many other tricks that help eliminate our wants, prior beliefs, and desires from biasing the results.
"A scientific man ought to have no wishes, no affections, a mere heart of stone."
– Charles Darwin
On the other hand, you have a large group of people brought up with religion. They're taught that they're sinners even though they never did anything wrong. They're told that God is loving, just, and never makes mistakes, yet they can see a staggering amount of misery in the world. They're taught that all the suffering in the world is part of some plan, yet it makes no sense. They're taught that thinking is wrong.
"Divine revelation, not reason, is the source of all truth."
– Tertullian of Carthage (150-225 AD)
In other words, if logic and science prove that something can't be true, but you have faith, then your faith rules the day.

(From our shameless commerce division: I wrote an entire chapter of The Religion Virus devoted to this very topic. It's what I call religion's "immune system" which evolved to defend against the rise in scientific methodology that began with Aristotle. Click here to learn more.)

AA is a cherished institution that has helped millions overcome their addiction, and many of these people are fiercely devoted to it and its principles. But the core job of science, its raison d'etre, is to ignore our feelings and find the truth. The question is simple: Does AA do more good that harm?

Unfortunately, the religious training of many seems to make them unable to look at this question objectively. I can dismiss the name-callers and "shouters," but there were a number of very thoughtful replies by AA members that were nothing more than assertions of faith. Roughly speaking, they argued:
  • It worked for me, so it's good.
  • You obviously never attended so you're uninformed
  • Those whom AA can't help don't want to be helped
  • It works for 30% of participants, so the other 70% are responsible for their own failure
  • I'm a "militant atheist" so I must be wrong.
But these arguments completely miss the point.

The point is that science doesn't care about your story, or your beliefs, or what you want to be true. Science cares about results. If a person attends AA are they more likely or less likely to successfully fight their addiction? Not you, not your brother, and not your uncle or mother. It's only the overall success rate that's being measured.

People trained in religious, faith-based thinking don't seem to even understand this distinction. They argue from personal experience and from what they want to be true, or believe to be true. They don't understand scientific methodology.

It may very well be that AA does work, that these scientific studies were flawed in some way. But the right way to find the truth is not by arguing from faith and wishes. The right way is to find the flaws in the science, to divorce ourselves from what we want to believe, and devise new experiments that will reveal the truth.

Lives depend on it.


  1. Hi, again, Craig,

    As a trained scientist, an atheist, and an AA, I will try to get this across again. Alcoholism, by its very nature, cannot be treated if the subject is not willing, no matter what program or lack of such is attempted. The main study you cited in the original article was based on a group of people who were arrested for public drunkenness. So, a) they may not have been alcoholic at all, and b) they were *compelled* to attend AA. So, the study did not use identifiable alcoholics, and they did not use willing subjects. To use this study to back up this assertion you are flirting with is comparing apples to oranges. You then go on to assert that, because this flawed study proves that AA doesn't work for people who are forced into it, it must be bad for alcoholics. But, statistically, only a third of the people studied were alcoholics. Oddly enough, the success rate of AA in the study was 33%. Coincidence?

    Does the religious language of AA turn off some people? Absolutely. It turned me off the first time I tried it. But I subsequently learned that I was using it as an excuse to keep drinking. When I was *willing* to use the tools that AA provides, I got sober. It had nothing to do with religion, and the faith it required was a faith that if it worked for so many others(science, not hocus-pocus), it could work for me, if I could find a way to reconcile my atheism with the program. This was surprisingly easy to do, once I was truly motivated.

    AA in its god-based form works well for most willing participants because, like it or not, most people believe in a god of some sort. I am in the minority, but it's a strong minority and I am well-supported by those who do believe. There is always going to be a wide-cross section of beliefs in the meetings, and some meetings may seem more religious than others. But not all meetings are alike.

    The hardest thing for non-alcoholics and scientists to really wrap their mind around is the disorder that tells an alcoholic they don't have a disorder. Many will relapse because of this, in and out of the rooms of AA.

    I also work with a cognitive behavioral specialist and I learn more and more about my disorder all the time. So far, if I sweep away everything to the bare bones of AA it falls directly in line with the scientific work I am doing with a highly trained specialist. There is no conflict.

    I understand that you are trying to do a good thing and that lives depend upon it. But it is flawed thinking with an anti-religious bias motivation that is doing the actual harm by convincing alcoholics who really are looking for a reason to keep drinking that AA won't work for them. And it might. It depends on them. There is no pill to cure this disorder. But there are respected, recommended treatments, and AA is one of them. As my shrink would tell you, "It ain't perfect, but it's the best we've got." And even if there was a pill, the alcoholic would still have to be willing to take it.

  2. Tedi - thanks for your post, it was long and thoughtful. Let me address some of your points.

    "Alcoholism, by its very nature, cannot be treated if the subject is not willing, no matter what program or lack of such is attempted."

    This is the foundation of AA, yet has it EVER been shown to be true in a scientific study? As far as I can tell, it is a faith-based statement.

    In fact, at least one of the studies cited by "A. Orange" was forced participation in a medical program, and it worked better than AA. So on the face of it, there is evidence that forced participation does work.

    In other words, the fundamental premise of AA may be wrong, at least for some people. A well-designed scientific study could discover this, but a faith-based "stick to the party line" doesn't shed any light.

    "Does the religious language of AA turn off some people? Absolutely. It turned me off the first time I tried it."

    So why doesn't AA develop several approaches, and counsel people to try the one that best fits their needs? How many addicts left, never to return, rather than sticking it out as you did? Sticking to a program that doesn't work for the majority of addicts, without at least trying new approaches, strikes me as short sighted.

    "The hardest thing for non-alcoholics and scientists to really wrap their mind around is the disorder that tells an alcoholic they don't have a disorder."

    Not true. This is easy for anyone to see except the alcoholic.

    "AA in its god-based form works well for most willing participants..."

    This is the ultimate cop-out, and I've heard it over and over in this discussion. If someone succeeds, they must have been willing. If they failed, they must not have been willing. Our program works, it's the addicts who fail.

    That totally lets AA off the hook. Let me illustrate: What if 99% of AA participants failed to kick their addiction, would that mean that those 99% were "unwilling"? What if there was another program that achieved 50% recovery rates, in a properly-conducted scientific study? Would you still claim that AA was the best approach?

    My point is not that AA is bad – I still have huge admiration for it and the sponsors who make it work. But I strongly object to the unscientific defenses I've heard here, and to people's unwillingness to even discuss the scientific studies rationally.

    "As my shrink would tell you, 'It ain't perfect, but it's the best we've got.'"

    Exactly. It's the best we've got, but there are scientific studies that show we might be able to improve it. Why are you so adamant that those studies are wrong or irrelevant?

  3. Andy here, Craig.

    You write:

    "So why doesn't AA develop several approaches, and counsel people to try the one that best fits their needs?"

    This sentence illustrates your deeply held prejudices about AA.

    You seem to assume here that AA "counsels people". Wrong assumption.

    You seem to assume that AA does not have several approaches. Wrong assumption.

    You write:

    "Would you still claim that AA was the best approach?"

    This is so ignorant I have to play a little game called student teacher here. You are the student. Can you identify your assumption as it relates to your question?

    Teacher waits patiently while student scratches head and finally says, "I'm assuming you AAs believe AA is the best approach?"

    Teacher: Yes, you are, and once again: you are wrong!

    Here is the one fact you have correct: "AA is a cherished institution that has helped millions overcome their addiction."

    Period, Craig.

    Has AA knocked on your door? Has AA ever sent you a bill? Has AA ever asked for a scientific study? Does AA even formally ally itself with the so-called "recovery industry?"

    The answer to all of the above is no.

    Does AA charge anything for anything? NO!

    Are there religions out there asking 10% of people's incomes and fleecing them like the little sheep they are? Yes.

    Is AA fleecing or deceiving anyone? No.

    We share our experience, strength and hope. It worked for me. If you do this, it will work for you.

    If it did not work for you, you did not do this.

    Sorry. That's the case Craig. [I think you might be able to trigger a nice case of alcoholism if you start today. Drink for 20 years and then you can find this out for yourself.]

    Another true thing you wrote: "If someone succeeds, they must have been willing. If they failed, they must not have been willing. Our program works, it's the addicts who fail."

    Why does that bug you? It's the truth. We don't make any guarantees about AA.

    We have meetings. There is coffee. Sometimes cookies.

    Why do so many people outside of what we do care so much about what we do? We do it for ourselves, Craig. Not for you. We actually have language in our traditions that literally states: we really don't care what you think.

    I'm personally not so good at "living and let living" when I see ignorant people spreading disinformation about a group that saved my life.

    Stick to the one fact you might be able to keep in that head of yours: AA has saved millions and continues to.

    -- Andy

  4. Andy (and others), one last question. If AA could be made better, would you embrace the change? What if some local AA group tried a new approach, and 60% of the participants were able to stay sober long term – what would you say?

    And why do you keep asserting that such a thing is impossible? That's what I hear you saying. It may be impossible, but how can you know if you reject new ideas, reject criticism, and reject evidence that improvements are possible?

  5. Craig,

    Thanks for your thoughtful response. The problem inherent in your question is that everyone in AA works it in a way that works for them, within the framework of the 12 steps. So, other than the twelve steps, it changes with the individual. If you have a sponsor that you're having a hard time staying sober with, you change sponsors and find someone with a different approach. And most people interpret the 12 steps according to their individual situation. The big book gives us direction in that regard, but even the steps are considered "suggestions". What matters most to those in AA is that the person stays sober.

    You also talk about AA like it's a single entity when, in truth, we are only loosely associated. Each meeting is an independent entity. So, if we did want to change AA, we could only change the group we attend, and it would be a matter for the group conscience. We can change our group whenever we want to. I'm certain we would change it if we felt a change was necessary based on clear and conclusive evidence that something better existed.

    Again, we care about staying sober. And in our literature it says we will go to any lengths. So, if something works irrefutably well, we would certainly try it. It also says that if you find a better way, our hats are off to you. So far, I haven't heard of an approach that improves AA, only criticism of what it currently is.

    I'm sorry if it seems like I am dancing around the issue, I'm really not trying to. I just think you really don't understand how it works. I think it's very hard to understand how it works until it has worked for you. I wish I could give you a better answer. But for me, it's not faith. It's clear evidence. I wasn't sober. I worked the steps. Now I'm sober. Nothing else ever worked. I know for a fact that working with my shrink helped too. But I'd worked with him before without AA and wasn't successful.

    So, I guess the only clear answer I can give you is that yes, we might be willing to change AA to improve it. But to do so, you'd have to change every one of the thousands of groups throughout the world. It's not like you can go to the "head office" and they send down a directive. They can't tell us what to do.

    Does that help at all?

  6. You ask: "If AA could be made better, would you embrace the change?"

    I can hardly add anything to Tedi's articulate and even handed response. He is an excellent example of the kind of spiritual growth that can accompany time well spent working the Twelve Steps.

    If there is one thing I might add it is as follows. I cannot promise that you will understand it but it is how it is: your question once again contains within it assumptions that don't really work with AA.

    You write:

    "What if some local AA group tried a new approach, and 60% of the participants were able to stay sober long term – what would you say?"

    I know that this will be hard for you to believe but it is THE truth: 100% of the AAs who helped me get sober are sober today! I have two sponsors. Both entering the 30 years of sobriety. I have 11 years. I just visited my old stomping grounds and visited with dozens of AAs who could tell stories about me when I was the shaking mess that staggered through the doors. We laughed about how screwed up I was. Why is it funny to us? Because it is behind us. Because we are useful to others who "want what we have."

    So this 60% statistic that you seem to believe is some sort of dream goal that we should want to achieve... it's a laughable joke to us.

    100% of us are sober.

    But you want to know how many AA's sobriety I am responsible for? ONE. Mine.

    Do you think that we are some kind of institution? Who do you think we are doing this for? Do you think we accept government or private funds? Have you tried to learn a single rational thing about our organization?

    "Alcoholics Anonymous is a fellowship of men and women who share their experience, strength, and hope with each other that they may solve their common problem and help others to recover from alcoholism."

    That's it. We don't keep records. We only seek to be as useful as possible to the suffering alcoholics who willingly walk through the door. Like me. I was one of them. My first visit was 1992. I was not ready. My next visit was 1998 and I have been sober since then.

    Are you going to wonder "how AA failed" me in 1992? Hmm... it was the same program in 1998? Why did it succeed then? The difference was in me: in 1998 I had had enough. Plain and simple.

    All these poor people you believe are suffering because "AA makes them worse" are people who are simply unwilling and not ready to get sober. Why is that so hard to understand?

    Contrary to the message of your original post: AA is empowering. When I used MY WILL to work the steps, AA worked. You will hear this same story about... two million times. Sorry that's not enough for you but we're happy with it!

  7. I think continuing to argue the effectiveness of the program is rather silly at this point. As you point out, the true believers won't listen to any scientific data you present. So, to answer the question posed by this topic; yes, AA is a religion.
    The courts have ruled that people cannot be forced to attend AA or any 12-step program based on the religious component contained therein on several occasions. Even attempts at secular 12-steps are inherently religious because of the need for a "higher power". No matter how you phrase it, in order to follow the program, you have to believe in some entity out there that is more powerful than yourself, that is capable of changing you where even you are not, who cares enough to do so, and who doesn't expect you to do it for yourself. That is not only religion, it is a very Abrahamic religion.

  8. proudheathen, you're wrong, but you, too, are going to believe what you believe, so I'll just save my fingers.


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