Bill's Notes

I went to my first AA meeting in a while, and the best one I've been to in ages. Back in early recovery, the meetings were amazing to me. I'd go in craving alcohol, desperate to get through the evening without getting a drink, and by the end, I'd not only have the hope that I'd make another 24 hours — I usually felt pretty good.

Since then, the past 17 years or so, meetings have been very hit or miss. I go occasionally, but forget about them for years at a time. Sometimes I'd get some relief from my moodiness or whatever was bothering me, but other times, not much would happen. This was particularly true in the Malvern Clubhouse, which was very near where I worked for six years. I know a lot of people love the Malvern clubhouse meetings, but they rarely did any good for me.

Anyway, down in Florida, I stumbled across one of those great meetings. Perhaps it was because there were a lot of people about my age, and there was a nice mix of men and women, and because they were mostly educated professionals like me. For once, I didn't feel alone. I made a couple of friends right away — and walked away thinking, shit, I've been looking like this for a meeting for years, and here it is, and I have to go back home the next day.

It was also a meeting where there was real recovery and real honesty ... and I felt a couple of days of real peace. It's hard to describe what an AA meeting can do to a recovering alcoholic. I go in, often filled with hardened resentments and walk out grateful, hopeful and ready to move on.

I also uncovered something. A desire that I didn't know was there — I realized, after a few days, that I've been denying how much I want to drink. I recognized that I've been relying on myself and my own strength to keep myself sober ... I ... I ... I ... I. But that's not how I got sober. "We" got me sober, and "we" will have to keep me sober. I can't do it on my own and not be filled with resentment and anger and an enormous amount of stress.

So I guess if I have one resolution for 2007 — work the program again. But will I? There's always the self-knowledge trap. Self-knowledge is great, but it's not enough. It doesn't get you better, but it makes you feel a little better. But real change and real growth takes action.

Regarding former U of VA student Liz Seccuro's filing charges against her rapist, who contacted her via snail mail as part of Step Nine of AA 20 years after raping her. Here's my take on Step Nine if you are an unprosecuted felon:

1. Step Nine does not give you carte blance to contact people. If you're a rapist, do not contact your victim at her home address. To a victim, it feels like a massive invasion of privacy. Guess why? It is. Think about it. You're a rapist. Now you've just told your victim you the rapist knows where she lives. Not only that, you probably cyber-stalked her to get the address, and she's sure gonna be spooked about that. That's the message the letter sends merely by showing up in her mailbox. You've violated her once; the letter violates her again.

And guess what? Every society, including ours, has mechanisms for dealing with situations such as this without requiring the perpetrator to directly contact the victim. In some societies, it's the tribal chief. In ours, it's the justice system. Yes, the justice system is not just for victims, part of what the courts do is give perpetrators a chance to "pay their debt."

2. Step Nine does not permit you to make things worse for others so that you can ease your conscience. Did you get drunk and sleep with your best friend's wife? Guess what: You can't damage their marriage so that you can feel better about yourself. Some burdens you just have to flat-out carry. In fact, part of your penance is to carry that burden, quietly, without complaining. If it's too much and you want to whine about it, find a therapist.

3. Unless you can really empathize with others, that is, really put yourself in their shoes, don't even try to attempt Step Nine with that person. That state of empathy takes a long time for an alcoholic, maybe a couple of decades. Any attempt at minimizing, or bad motivations, will be obvious. And piss the victim off.

4. Whenever you do Step Nine, do not give the victim the problem of justice. For example, don't say, "I'll do anything you want to make up for it." Why not? Because you've just made justice her problem, not yours. It's not her job to come up with the 12 labors of Hercules for you. It's not her job how to figure out how to make things right. It's yours.

5. You will not "get drunk" if you fail to do Step Nine. While AA has a lot of great things about it, there's this underlying belief that unless you do all the steps, you'll get drunk again. It's not true. That's an excuse people use. The only step you need to do perfectly is Step One. Do the first five steps — that is, clean up, do your moral inventory. Then cope.

6. You may have done things while drinking that are felonies, for which the statute of limitations has not run out. You have to make a choice: Do you do your time — or not? Follow your conscience. If your conscience tells you that the solution is to live your new life best you can, to do good, then do that. If your conscience tells you that you have to pay for your crimes, then do the following:

A. Contact a defense lawyer.
B. You and your attorney go down to the police station together. Because you know what? The police do want to hear directly from you.
C. Think about any accomplices. Are you going to send others to jail to ease your conscience? It depends on the situation. Keep this in mind.
D. Guess what? The justice system provides a time for criminals to apologize to their victims. Usually, it's right before sentencing. And if you think about it, that's the best time for Step Nine in such circumstances. More important, the victim has control over whether to show up or not, whether to speak or not.

My two cents. YMMV.

Recently I've seen data that talks about the success rate of rehabs and 12-step programs. The data is all over the place. Individual rehabs will cite rates as low as five percent, others about 17 percent, others about 30 percent. "Old" Alcoholics Anonymous makes claims of 75 percent; modern AA indicates success rates are far less. Some suggest, and have evidence, that the "success rate" for AA is about the same as trying on your own.

To which I say: If you're an active addict studying the success rates of recovery, you're asking the wrong question. What you're doing, even if you're following the right logic and are utterly right on the facts, is bullshitting yourself. This is one of the most difficult concepts to explain to people. You can be absolutely right and still dead wrong.

Some criticism of treatment programs discuss flaws in the disease model of drug and alcoholic addiction. These say the key issue is "choice."

I have 18+ years of sobriety after a nine-year run with alcoholism, and I think I know something about this subject. My answer — there is no question that alcohol and drugs use at frequent or high levels can impact your thinking in dramatic ways, and deeply impinge your will to make further choices. Whether you want to call this result a disease depends on your definition of disease. Call it Fred if you like. (No actual Freds were harmed in the writing of this post.)

I'll say this much: Alcoholism and drug addiction are not diseases in the sense that influenza or malaria is a disease. And Alcohol and drug addiction do not respond to "treatment" the way a doctor would treat influenza or malaria, either.

That said, I believe that while the brain and the mind are not exactly coterminous, they are pretty clearly connected, and whatever the "mind" does in this life is done through the brain. I don't care how mystically enlightened you are — in this life, if you've got a brain problem, you've got an ensuing mind problem.

And addiction is a mind problem that becomes a brain problem that becomes a mind problem. See, mind impacts brain — your brain rewires itself based on stuff your mind does. If you want to call this mind-brain-mind-brain problem a disease, you're welcome to, IMHO. If not, fine. If Fred, fine. Define things as you'd like.

Whatever you call it, "treatment" for addiction is vastly different than other medical treatment. Some "treatment" programs focus on this purported gap between the brain and mind, otherwise known as spirituality. This is clearly different from taking penicillin for an infection. "Treatment" for addiction involves re-establishing a person's choice. To me, "successful treatment" of addiction means the person has a restored volitional capability to choose to use the substance or not UNDER NORMAL AND ACTUAL CONDITIONS OF THE "TREATED PERSON's" LIFE. People subject to abnormal amounts of structure and support, for example, may temporarily recover the power of choice. Similarly, people subject to grave threats may do the same thing. That's irrelevant to me — the key is under the person's actual life conditions, do they have a restored power of choice to use or not when undergoing this or that program of recovery?

But isn't that an unscientific question? That's why I think the studies of recovery rates are irrelevant — it's not about what people do with their choices, it's that they have a real choice. I'm dubious about social science in general, but that issue of choice is a question that an individual, and an individual only, can answer: I have undergone this "process" or whatever, and do I have the power to choose to NOT use/drink in my normal daily life?

Some AAers will say, yes, I have the power to choose, but only if I move my own power to choose on this topic to a Higher Power, that is, to that gap between mind and brain. Fine. I do that myself, and it works great for me when it comes to booze. Indeed, an essential part of recovery was when I recognized I always had a choice. To those who speak of the disease-model of recovery as not involving choice simply don't understand AA or what it teaches. Choice is crucial to AA.

But the problem is we have a tendency to think of "choice" as involving a mental act only, an abstract decision-making thing. "I shall wash my car today." Will you wash your car? I don't know. You may be the sort of person who decides and does? But you may be the sort of person who says, "Ah, I'm feeling blue right now, and I want some ice cream instead." Or you may be the sort of person who says, "I tried to wash my car, but we're out of soap, and it's too much of a hassle today to go get more, so I will not wash the car today."

What AA, and healthy cognitive psychologists will tell you, is that there are three main components to thinking: what we might call our rational side, our emotions and ... drum roll ... our behavior. Behavior is crucial to our thoughts. Our brain rewires itself based not only on what we think and what we feel, but what we do.

What AA tells you is this: Your ability to choose NOT to drink is deeply impaired. That's because your thinking is impaired, especially in two of the three crucial areas, the rational and the emotional side. Those who do not recover are those who try to reason their way to the choice not to drink, or those who try to rely on emotions to give them the strength, such as moments of great inspiration — invariably, it's a temporary victory, and goes away when one returns to the normal conditions of life. We in AA do not know why this is so, and we do not know what you want to call it (yes, call it Fred if you like, we only know based on our own experience that two-thirds of what goes into our thinking cannot help us in this volitional area.

However, we still have other choices we can make. We may not be able to choose NOT to drink, but we can choose to do other things. We can choose to go to a meeting. We can choose to pray. We can choose to avoid people, places and things that put us in danger of drinking. We can change our normal conditions of life to make our choice not to drink more easily. We can get a sponsor.

Soon, we in AA discover that not only can we assist our decision not to drink based on our behavior, but we can strengthen the emotional side. We can "share" our emotional pain at meetings, and receive love and support, thus temporarily relieving that pain. Thus, our thinking improves in two areas.

Some of us continue to strengthen the "rational" side as well. We know that we need to use our reason to guide our behavior and our emotions. Reason is still in the driver's seat. But we in AA don't say, "I will not drink for the following reasons ..." Instead, we say, "I will do this and that in order to improve my odds of recovery, and I will avoid x and y." We say, "I will attempt to deal with emotion x by behavior y." We say, "I will call my sponsor when I have the urge to drink, rather than argue with the desire until it becomes a major urge." We don't run straight at the abstract choice of not drinking, if we can avoid it.

And yet we may still face a moment when the only thing stopping us from drinking is the movement of our arm. Even then, we do not argue with the reasons (it will be twisted if we've gotten to this point) or with the emotions (similarly twisted). Instead, we will recognize that we can choose to move our arm (which is a behavior) or we recognize we may choose to get up and go elsewhere, call our sponsor or other AA friend, and then begin better behaviors that do not let us to this kind of emotion-shattering moment. Addicts who recover find they behave their way to better thinking, which in turn leads to better choices. (Keep in mind the emotional side of things complicates this process.)

At least, that's how I look at it. Is addictive drinking and drug use a choice? Yes. Is it a disease? Depends what you mean. What is treatment? Re-establishing choice. Does "choice" mean, "I decide x, and thus x happens?" No. It means choosing behaviors and coping with emotions that impact your thinking in positive ways, enough to live out your goal not to drink.

And all this gets lost in studies on recovery rates.

FWIW.

*****

UPDATE: By the way, I was thinking about the role of honesty in "treatment." AA has a statement that only those who are incapable of being honest fail to recover. As harsh as it sounds, I believe it to be the absolute truth. And here's why: The addict tends to be dishonest in one key area of thinking — and that's the decision to act instead of think or feel. The AA recovery program requires you to be honest enough to do the required behaviors instead of relying on your own rational thinking or emotions to get rid of an unwanted desire.

It also involves being dishonest about behaviors that lead to drinking, as well as dishonestly ignoring thoughts and emotions that lead to drinking.

For example, if I feel crappy, I know that I need to DO something. Talk to someone, or help another, or get out of isolation, instead of trying to correct the emotion on my own or try to reason my way out of feeling that way.

That is, if I want a friggin' drink, I want a drink. If I am honest with myself, I know I need to do a behavior right then, and everything short of a behavior is dishonest lying bullshit. Addicts who don't recover (and want to) are those who aren't honest enough at this moment — they lie to themselves about the need to act. Instead, they try to think or emote out of the process. And eventually lose.


UPDATE 2: Also, by the way, the focus on honesty is one reason Theodore Darymple thinks addiction "treatment" and medical treatment are two different things. You can be as dishonest as you want, but if you take your antibiotics for an infection, you'll get better. Unless you lie to yourself about taking the meds, but that would be too weird ...

My friend Dean has a few issues when it comes to AA.

There's this:

Powerless? Bite my crank. I am not powerless. I've just gotten too self-indulgent. Don't tell me I'm powerless, because I'm not. The truth is, I've become a self-indulgent, self-obsessed jerk and I need to get this s*** under control.

Ouch. Plus:

I like the sauce too f***ing much. That's been the problem all along. 12-step programs may help some people, but honestly: they are bulls***. They really are.

And this:

This weekend, I went up to my sister-in-law's house to celebrate Memorial Day. At that get-together, lots of people had booze. Beer and wine were everywhere. When I went there, I made a conscious choice: I could drink booze, but I wouldn't. Because if I had indulged that urge, I would have been a smarmy, self-indulgent ass. So even though several opportunities to drink presented themselves, I consciously chose to say, "Nah, I'd better not. I'll just be a jerk if I do, and while I might enjoy myself then, I won't enjoy thinking about it later."

Dean, Dean, Dean, buddy. Love ya. Really.

This leaves me in the awkward position of defending AA. Why is it awkward? Because I don't go to AA, but I got sober in AA. Without AA, IB Bill would have wrung up so many DUIs by now my license would be suspended forever and I would probably be chronically unemployed and living in my mother's house as a pathetic loser in Florida. Not only don't I drink, but I really don't think about it. I don't get that cringing sensation in the gut when other people talk about drinking. On occasions around alcohol I might mention that it would be nice to be able to drink. But I won't. I choose not to drink. And then the thought is gone and that's that. I enjoy myself and even forget entirely that other people are drinking.

What AA did, and the reason I defend it to this day, is help me stick with that decision not to drink. I went to 18 months of AA meetings, almost every day, and did "the program" pretty thoroughly. I stopped going to meetings about 16 years ago. I am one of the few recovering alcoholics to join the U.S. Peace Corps (there's lots who join both groups, just in the opposite order, Peace Corps, then AA :) ) I lived in a house filled with people in recovery for years, helping others get sober.

Here's the bottom line: AA works. Don't be afraid to join, don't be afraid to work the program. It works. If you work the program and don't fight it, it's a guaranteed way to get sober. You do the program, you "surrender to the process," and you'll get sober. I've never seen it fail because God doesn't fail. Not will you get sober, but the desire to drink will go away; in some cases, such as mine, God will pour out His grace so much that you literally die to alcohol. And after that happens, you can live your new life without alcohol and without missing it.

So AA is not bullshit. The exact opposite. It's a beautiful thing and one in which millions of people have found their lives restored. I've sat in rooms with men in their 60s, sharing how they abused their wives and ruined their relationships with their children, and talk about the beauty of knowing that their grandchildren had never seen them drunk and love them, and how their children, still wary, have begun to show them respect. I've seen women talk about how they lost custody of their children because of alcohol and drugs, yet they're piecing their lives together. I've seen relationships restored, love found, and hope renewed as people get sober.

But be forewarned — working the AA program for real is extremely strong medicine, equivalent to taking half a fatal dose of medicine, and it's not for the faint-hearted. You need big, brass balls / ovaries to work AA completely because you'll one day have to peer directly into your own soul without the comfort of a single rationalization or hiding place — and you're not going to like what you see there. And afterward, even if you get better, you won't be like those people who go through their lives without ever looking directly into their soul. It's the closest thing to the Total Perspective Vortex or whatever it was called in Hitchhiker's Guide. You'll know God, and you'll know yourself, and before you get that grace you'll know exactly where you stand.

Now, if it's so great, why don't I go? For one thing, and this sounds selfish — I don't need many meetings anymore. I took the medicine and now I maintain myself with my Christian faith. AA is a spiritual program, and I continue my spiritual life in other ways. Still, a few meetings a year help. Now what about helping others? Yes, I know. I keep meaning to join up again to serve others. It's on my list :)

But there's another reason I don't go to AA much: Dean has a point. Some AAers can indulge in extended, insufferable pious moralizing. Some meetings are cultish. Sometimes crazy people take over certain meetings. There are a ton of young people who have nothing more wrong with them than their parents didn't bother to raise them or teach them any values, and they have been shoveled into AA by a combination of parental neglect, schools that don't have a clue, and the recovery industry. And then there are people who swear AA is the only way to get sober and if you don't get sober, you're DOOOOOMMMMEEEDD! Other people judge your sobriety, saying if you don't go to AA you'll never be happy.

To sum up: If you want to get sober and want a guaranteed way, then go to AA. Do the first five steps without any reservation. Only do those five steps in the first year. Choose your sponsor carefully — it should be someone you want to be like, and that's not necessarily someone who volunteers for the job. Don't make any big changes in the first year. Stick with the winners and the mature people and steer clear of the nuts. Even in early sobriety you should know the difference. Stay out of relationships unless you're already in one. Then after a year of sobriety, find a good therapist — not someone who will take your insurance and tell you to go to meetings, but someone who will focus on helping you develop life skills. Go and find God for real, not a nebulous higher power you get to create in your own image. God is a jealous God and you don't get to tell Him what He's like; He'll tell you.

And then when you're done, you'll be sober and know some peace ... but most people won't know what the heck you're talking about most of the time :) Many people will actually condescend toward you! But others will understand, and then you'll have found a kindred spirit.

FWIW. YMMV.