AA: Cult or Cure?

a shocked physician wrote:

I should clarify: I am shocked that psychiatrists allow such non-scientific drivel into their specialty. AA and its precepts are densely interwoven throughout the addiction treatment industry as well as some non-addiction psychiatric disorders, despite the fact that AA itself is a decentralized organization.

All of the 12 steps are highly problematic and non-scientific, but the first step takes the cake for extreme illogic: you are required to admit powerlessness over your habit. Thereafter, you must submit to a higher power. This automatically coerces you to castigate yourself and deprives you of your free will. Ultimately, the concepts in AA are quite rigid and certainly not backed by science.

The last point I'd make is the broad concept of addiction as a disease. It's important to note that despite some extraordinarily destructive behaviors resulting from addiction, defining addiction as a disease and then comparing it to other diseases, like diabetes, heart disease, or cancer, is inordinately dishonest. Addiction refers to a a strongly ingrained habit that brings about incremental reward. Examples include habitual overeating, drinking too much, and even good habits like running. Most such habits engage the dopaminergic mesolimbic-prefrontal cortex pathways. Some structural changes take place in these and other brain areas with 'addiction,' but there is evidence that such changes reverse with stopping the habit. Defining destructive habits as a disease 'medicalizes' the individual and plugs him into the treatment industry, for better or worse (most rehabs are 12 steps). It is absolutely the case that some people are much better off without ever engaging some bad habits again, but for those who seek AA as a 'treatment,' they are recommended to go to as many 'meetings' as possible. Many of the 'success' stories of AA end up going to a few meetings a week for the rest of their lives - an incredible time commitment. Note that while it is extremely difficult to perform long-term statistical outcomes studies on individuals in AA due to the anonymous part, some estimates place the 'success rate' at no better than 5%.

If a patient with a melanoma on his back came to see his physician for treatment, he would almost certainly laugh if the physician told him to go to meetings and profess his powerlessness over melanoma, and that only a higher power could cure him. Currently, the psychiatric treatment industry first disingenuously calls addiction a chronic disease (and thus any patient with addiction is a lifelong addict despite abstinence), and then proceeds to 'treat' this serious disease by filling your ears with plates of asinine tripe.

George Washington died after his physicians repeatedly bled him for an epiglottitis, a serious but survivable upper respiratory infection. In Medicine today, AA is the equivalent of bloodletting.

Step 1 wrote:

a shocked physician wrote:

I should clarify: I am shocked that psychiatrists allow such non-scientific drivel into their specialty. AA and its precepts are densely interwoven throughout the addiction treatment industry as well as some non-addiction psychiatric disorders, despite the fact that AA itself is a decentralized organization.

All of the 12 steps are highly problematic and non-scientific, but the first step takes the cake for extreme illogic: you are required to admit powerlessness over your habit. Thereafter, you must submit to a higher power. This automatically coerces you to castigate yourself and deprives you of your free will. Ultimately, the concepts in AA are quite rigid and certainly not backed by science.

The last point I'd make is the broad concept of addiction as a disease. It's important to note that despite some extraordinarily destructive behaviors resulting from addiction, defining addiction as a disease and then comparing it to other diseases, like diabetes, heart disease, or cancer, is inordinately dishonest. Addiction refers to a a strongly ingrained habit that brings about incremental reward. Examples include habitual overeating, drinking too much, and even good habits like running. Most such habits engage the dopaminergic mesolimbic-prefrontal cortex pathways. Some structural changes take place in these and other brain areas with 'addiction,' but there is evidence that such changes reverse with stopping the habit. Defining destructive habits as a disease 'medicalizes' the individual and plugs him into the treatment industry, for better or worse (most rehabs are 12 steps). It is absolutely the case that some people are much better off without ever engaging some bad habits again, but for those who seek AA as a 'treatment,' they are recommended to go to as many 'meetings' as possible. Many of the 'success' stories of AA end up going to a few meetings a week for the rest of their lives - an incredible time commitment. Note that while it is extremely difficult to perform long-term statistical outcomes studies on individuals in AA due to the anonymous part, some estimates place the 'success rate' at no better than 5%.

If a patient with a melanoma on his back came to see his physician for treatment, he would almost certainly laugh if the physician told him to go to meetings and profess his powerlessness over melanoma, and that only a higher power could cure him. Currently, the psychiatric treatment industry first disingenuously calls addiction a chronic disease (and thus any patient with addiction is a lifelong addict despite abstinence), and then proceeds to 'treat' this serious disease by filling your ears with plates of asinine tripe.

George Washington died after his physicians repeatedly bled him for an epiglottitis, a serious but survivable upper respiratory infection. In Medicine today, AA is the equivalent of bloodletting.

You babble like an inebriated podiatrist .

a shocked physician wrote:

I should clarify: I am shocked that psychiatrists allow such non-scientific drivel into their specialty. AA and its precepts are densely interwoven throughout the addiction treatment industry as well as some non-addiction psychiatric disorders, despite the fact that AA itself is a decentralized organization.

All of the 12 steps are highly problematic and non-scientific, but the first step takes the cake for extreme illogic: you are required to admit powerlessness over your habit. Thereafter, you must submit to a higher power. This automatically coerces you to castigate yourself and deprives you of your free will. Ultimately, the concepts in AA are quite rigid and certainly not backed by science.

The last point I'd make is the broad concept of addiction as a disease. It's important to note that despite some extraordinarily destructive behaviors resulting from addiction, defining addiction as a disease and then comparing it to other diseases, like diabetes, heart disease, or cancer, is inordinately dishonest. Addiction refers to a a strongly ingrained habit that brings about incremental reward. Examples include habitual overeating, drinking too much, and even good habits like running. Most such habits engage the dopaminergic mesolimbic-prefrontal cortex pathways. Some structural changes take place in these and other brain areas with 'addiction,' but there is evidence that such changes reverse with stopping the habit. Defining destructive habits as a disease 'medicalizes' the individual and plugs him into the treatment industry, for better or worse (most rehabs are 12 steps). It is absolutely the case that some people are much better off without ever engaging some bad habits again, but for those who seek AA as a 'treatment,' they are recommended to go to as many 'meetings' as possible. Many of the 'success' stories of AA end up going to a few meetings a week for the rest of their lives - an incredible time commitment. Note that while it is extremely difficult to perform long-term statistical outcomes studies on individuals in AA due to the anonymous part, some estimates place the 'success rate' at no better than 5%.

If a patient with a melanoma on his back came to see his physician for treatment, he would almost certainly laugh if the physician told him to go to meetings and profess his powerlessness over melanoma, and that only a higher power could cure him. Currently, the psychiatric treatment industry first disingenuously calls addiction a chronic disease (and thus any patient with addiction is a lifelong addict despite abstinence), and then proceeds to 'treat' this serious disease by filling your ears with plates of asinine tripe.

George Washington died after his physicians repeatedly bled him for an epiglottitis, a serious but survivable upper respiratory infection. In Medicine today, AA is the equivalent of bloodletting.