Speaking Up

daily gratitude list 3.17.23

I’m grateful for a cool, orange sunrise. I’m grateful for some pretty stirring, dramatic music (Tchaikovsky). I’m grateful for a new way of seeing things. I’m grateful for the change that happened. I’m grateful for big, fat pitches that even I can hit. I’m grateful to be sober today.

Happy St. Patrick’s Day! Every alcoholic’s favorite holiday! Actually, AA meetings on the topic of St. Patrick’s Day can be kind of funny, real alcoholics grousing about the bars being filled with “amateurs.” Hahaha. St. Patrick’s Day, a day when day-drinking is the norm, well, I’d just like to welcome you to my bad, old world, where every day was a mash-up of Groundhog’s Day, St. Patrick’s Day, with maybe a little Cinco de Mayo thrown in for good measure. Honestly, the only thing that could make March 17th better during my drinking days was if I could celebrate it at an airport or hotel bar.

How times have changed. I don’t ever mean to glorify drinking and when I say I think things are or were “funny,” it’s because it’s easier to describe them that way. The truth is most of those things were actually kind of sad and bleak when you looked at them from the right angle. Anyway, here’s something else that I didn’t think was funny:

The New York Times Comparing AA to “Faith Healing.”

A few prefatory remarks. I am mindful that there is nothing so sweet-tasting to an alcoholic as the opportunity to wallow in self-righteous anger. I know those feelings pair well with a flinty Sauvignon Blanc. When I read this last Saturday, it did light up a those lot of neural pathways. The non-controversial part of the essay’s premise is that no one should be forced to pursue a treatment program that violates their religious beliefs. As someone who has tried First Amendment cases, that’s a principle I can get behind.

Where we part company is when the author, Maia Szalavitz, asserts that AA is nothing more than peer-support, a helpful add-on to the non-secular, real therapy that actually cures alcoholism. She asserts that AA is really a form of Secret Christian Worship that is suitable only for protestant alcoholics. But then she did this thing, where she quoted the first half of a sentence to support her thesis, and then omitted the last half of the sentence, which, of course, completely contradicts her thesis.

In the wild, the traditional advice on encounters with dangerous animals is to not run away, lest you inadvertently ignite their predatory zeal. That pretty egregious misquote was what got me going. I used to get paid to cross-examine people. So I’ve written this. It’s still a draft, I plan on sending it this weekend and seeing if the NYT will publish a response. I would love your thoughts and comments. But there is a point I want to make first.

My personal view is that the attitudes around anonymity and AA need to start changing. I think, too often, our inclination is to treat AA like Fight Club—and we all know the First Rule of Fight Club. But the AA equivalent of the First Rule of Fight Club is very, very different:

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Each AA Group has but one primary purpose, to carry its message to the alcoholic who still suffers.

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Of course, we should never disclose the things that are disclosed to us at meetings and we should never choose for someone else whether they are public about their alcoholism and addiction. There are two sides to that coin, though. If I want to be public about my alcoholism, then everyone else should be ok with that, too. When you delve into the history of AA, it becomes clear that much of the impetus behind the development of the anonymity traditions was to hobble Bill W. a bit. I think the “Go Slow Boys,” (that’s what Bill called them) saw Bill as a bit too piratey for their tastes and were concerned about having the program being too closely tied to the fate of one person. Especially when that person was the man whose icon, if there had been such a thing in 1939, would have been a loose cannon.

When I wrote those pieces about ChatGPT last week, one of the things I realized was that while everyone is focused on how AI will shape the world, there’s not as much concern about who’s shaping AI. As I questioned ChatGPT, I found the same bias that infects the essay in the Times—that AA is faith healing, just a support group. Of course, as the New York Times essay suggests, the idea of letting a cancer support group drive cancer treatment is insane. But that completely misses the point: AA is not just a support group, a club for broken toys to sit around and grouse and drink bad coffee in church basements, a weird secret worship society.

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AA is the most effective treatment for alcoholism and addiction that is out there.

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Seriously. The study that is cited in Maia Szalavitz’s essay actually proved it. She wrote this:

Many people find success with A.A. However, fewer than half of 12-step participants are abstinent for a year after starting, and it is clear that additional options are needed.

New York Times, March 11, 2023

She cites the same study I did when I wrote this: Guess What? AA Works! That study did find that only 42% of those who attended AA meetings were able to maintain sobriety for a year. Here’s the half of the sentence she omitted:

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…compared to 35% of participants receiving other treatments including CBT.

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So here’s the thing. While we sit here with our self-imposed gags on, reveling in our anonymity, the people who don’t get us, don’t like us, don’t understand us, they feel pretty free to criticize us and the Program and they don’t feel any particular compunction to get it right, because they’re counting on us to not respond. Go look on Youtube for videos about AA. ChatGPT finally admitted that its misguided views on AA were principally based on the “opinions” of three people. Literally. My view is that until we are more willing to start talking about the Program and how it really works and how it really worked for us, and actively trying to correct the harmful misperceptions, well, I’m not sure we’re focused on the words that are right in front of us.

Each AA Group has but one primary purpose, to carry its message to the alcoholic who still suffers.

I think everyone’s path to recovery has to be their own. It’s the path back to yourself, so of course the journey will be very individualized and AA is not for everyone—that’s cool. What isn’t cool is to make false assertions about what AA is —to try and persuade people that they shouldn’t even try it. So, I’ve written this and I plan on sending it in this weekend. Will the NYT publish a response? There’s only one way to find out. Here’s the draft, and if you have thoughts or comments, I’d love to hear them:

AA is Not Faith-Healing

We write to you as alcoholics and and as people who believe that Alcoholics Anonymous saved our lives. As lawyers, we agree that no one should ever be compelled to seek “faith-based healing” for actual diseases and not just on First Amendment grounds. Unfortunately, Maia Szalavitz’s essay: “People Have a Right to Nonreligious Rehab” is an uninformed repetition of long-lived misperceptions about AA. That’s bad enough for the paper of record. But we think repeating these untruths actually does harm to those who suffer from our disease.

Ms. Szalavitz correctly zeroes in on one horrifying statistic—only about 42% of those who attend AA meetings stay sober for a year. But Ms. Szalavitz left out the end of that sentence from the Cochrane Group abstract:

…compared to 35% of participants receiving other treatments including CBT.

That’s the real point. AA is an effective treatment for addiction. “Opinions,” like Ms. Szalavitz’s view, that AA is just a support group, a covert form of worship, a religious coffee-klatsch, ignores contemporary evidence as well as the basic literature of the AA program. Even ChatGPT acknowledges that AA ought to be considered an evidence-based treatment for addiction:

“AA has been shown to be as effective, if not more effective, than some other evidence-based treatments in achieving and maintaining sobriety. “

ChatGPT, March 10, 2023.

It is a worse sin to repeat the false notion that AA is actually a form of Christian worship, or what you hear more often, AA is just too religious. This misperception is the real tragedy and it keeps more people away from AA than any other. The statistic we wish Ms. Szalavitz had cited is this one:

Only about 7% of the people who need help with this terrible disease will ever seek treatment.

We can argue about one-year sobriety rates for different treatment modalities, meanwhile, the house is on fire. Nine out of ten of us are afraid or unwilling to seek help. Publishing an editorial saying that AA is a para-religious organization requiring cult-like adherence to a bunch of outdated principles that are ineffective in treating addiction is not just untrue, it keeps people from discovering for themselves whether AA is for them.

While Ms. Szalavitz refers to Bill Wilson at the end of her essay, we don’t get the feeling she’s really read his masterwork, the thing that spawned all of those 12-Step movements: The Big Book of Alcoholics Anonymous. She correctly points out that Bill W. was not a conventional thinker, he did experiment with LSD and sometimes employed an Ouija Board in his pursuit of spiritual connection. The suggestion he simply parroted Christian orthodoxy in the Big Book not only seems unlikely, it doesn’t survive a reading of even the first chapter, “Bill’s Story,” much less the highly-specific and not very religious, “We Agnostics” and “Working With Others.”

Ms. Szalavitz cites the influence of the Oxford Group on the development of the 12 Steps as proof of the crypto-Christian nature of AA. Again, Ms. Szalavitz left out the end of the sentence. Bill Wilson parted ways with the Oxford Group in 1937, two years before he published the Big Book. Lois Wilson said they were “kicked out” of the Oxford Group because she and Bill were “focused too much on the alcoholism and not enough on Christ.” To be honest, there are more traces of Stoicism and Buddhism in the Big Book than Christianity. It’s worth noting that the book Bill cited for his spiritual awakening was not the Bible, it was “The Varieties of Religious Experience,” by William James.

The program of Alcoholics Anonymous does not require adherence to the tenets of any religion. It does not set forth any plan of worship. There is no one in charge of AA and no master plan, other than bringing the program to the still sick and suffering. The spiritual awakening that animates Alcoholics Anonymous is borne of the simple recognition that there just might be a power greater than us in the universe. It does not require the acceptance of any particular deity. In fact, what ultimately swayed Bill W. was the notion that he could construct his own higher power, rather than adhere to someone else’s formulation. If you’ve ever tried to find your own purpose, determine your own principles, and then worked to align your life with those principles and that purpose—well, that’s all the “religion” that’s necessary to work the 12-Steps. The necessary spiritual condition is summarized in one sentence:

“A willingness to believe in a power greater than myself was all that was necessary for me to make my beginning.”

Alcoholism and addiction are terrible diseases that ruin too many lives and lay waste to too many families Things are getting worse. We wish there were more effective treatments available, too. We wish we had way more tools than a book written in 1939. But the truth is, the principles in that book, as detailed in the 12-Steps, is the most effective thing we have today. The New York Times labelling AA as “faith healing” would be laughable if it weren’t so harmful. A central conclusion of Ms. Szalavitz’s essay, that there isn’t evidence to support AA’s effectiveness, ignores not only the indisputable fact that AA has helped save millions of lives but even the studies she cites herself.

As lawyers, when people present themselves and speak honestly and truthfully about their experiences, well, we call that evidence. Come to an AA meeting with us—we’ll introduce you to a lot of evidence that AA works.

So, we’ll see. I’ve come to see that the problem we should be focused on, given the Fifth Tradition, is that only 7% of the people who need help will ever seek it. We know what happens to untreated alcoholics and addicts. Last year, at least 100,000 of us died of this disease, it’s become one of the leading causes of mortality among men older than 35. The thing that took me so long to get is exactly the thing I need to be sharing:

AA Works.