From: carnes@quip.eecs.umich.edu (Richard Carnes)
Subject: Re: RR vs. AA, or RR + AA?
Organization: University of Michigan EECS Dept., Ann Arbor
Date: Mon, 28 Sep 1992 23:19:39 GMT

Robert Hartman writes:
>[...]
>I would appreciate it if you would simply relate the differences in
>approach, and leave out the explanations of why things didn't work for
>you, or might not work for others.  As a person who believes in
>rationality, why don't you just present the case for what you believe
>in, and let others present the case for what they believe in, and let
>each person decide for her- or himself.  

Other things equal, if I couldn't say something good about a program I
would prefer not to say anything at all.  But I don't think one can
describe RR's approach (and that of some alternatives) without
discussing the limitations of AA, because RR in part *defines* itself
by its opposition to some "irrationalities" that are intrinsic to AA;
as Trimpey says, RR is not "just an alternative" to AA, it is a sort
of anti-AA (my term, not his).

I don't know how to explain what RR is about (nor does Trimpey,
apparently) without explaining the problems that its members have, not
just with AA, but with the 12-step philosophy which so dominates
addiction treatment in the U.S.  The reason is that RR is not just
another program alongside AA: it is designed as a program, not
necessarily for everyone, but specifically for people for whom the
12-step approach is *counterproductive*, and to explain why a person
would want to adopt the RR approach one needs to explain why that
person would *not* want to use the *A approach.

A point that a lot of people seem to be missing: NO ONE is saying that
AA should disappear, or that it has not helped millions of people, or
that only stupid or dogmatic people stick with AA.  Rather, I am
explaining why AA is unsuitable and counterproductive in *some* ways
for *some* people.

Example of why AA would be unsuitable for a particular person: AA
teaches that you *need* the help of "a Higher Power" in order to stay
sober.  But *some* addicts, in order to recover, need to believe just
the contrary, that they can stay sober and clean on their own steam
*without* the aid of a Higher Power of any kind.  For these people,
the belief that they need a Higher Power *impedes* their recovery.
That's why I have stated that this 12-step idea about a Higher Power
does not apply to everyone, not merely because I don't think it
applies to me or because I think it is stupid (I don't), but because
of its potential and actual harmful impact on some real and often
desperate people, including me when I used to believe it.

The reason for pointing out the limitations of 12-step programs and
the comparative advantages for some people of the alternatives is not
to say that "my program is better than yours" or "I'm smarter or more
rational than you", but rather to *help* the substantial number of
people who will be aided and encouraged by reading such a critique in
a public forum.

Please note the great asymmetry of the relation between the 12-step
groups and the others.  If RR and the other alternatives were even
one-fifth as well publicized, established, and institutionalized as
AA, I would not be so insistent on presenting my viewpoints.  The
situation would be entirely different if the 12-step approach were not
the 800-pound gorilla of addiction treatment in the U.S.; but the *A
programs are so completely dominant (in a number of ways) that a great
many people think that the 12-step approach *must* apply to them, and
that if the 12-step approach does not fit or does not work with them,
then *nothing* will.

AA itself is responsible for propagating the misinformation that
"alcoholism" is a "univariate" disorder, i.e., a single disorder with
a certain, predictable course, and for which AA is thus a universal
treatment.  (Contrary to popular belief, there is no such medical
diagnosis as "alcoholism", which is an umbrella term.)  On the
contrary, because of the great variance among the conditions that are
collectively called "alcoholism" (or "problem drinking"), there are a
great many "alcoholics" or problem drinkers for whom AA is not an
effective treatment.

Believe it or not, some people have expressed appreciation to me for
my postings to a.r., apparently having found them worth reading.  The
interests of these people matter, I should think.  There is an
asymmetry between those who would like to see critiques of *A programs
on Usenet and those who do not want to see them.  If you don't want to
read such criticisms, it's relatively easy to avoid reading them; but
those who are interested in reading about both the pluses and minuses,
the advantages and limitations, can't do so if the minuses are not
there to begin with.

Obviously there is a lot of hostility and opposition to discussions of
limitations or deficiencies of AA and the 12-step programs in this
newsgroup.  But I think that that is a symptom of the whole problem
that I am trying to address, the overwhelming dominance of AA and
12-step programs in the treatment of addiction and the comparative
invisibility of dissenting views.  Professionals in addiction
treatment run into the same hostility when they criticize *A programs.
A kind of "tyranny of the majority" can result in the squelching of
views that the majority considers annoying or offensive or dangerous;
but that is a Bad Thing.  It is not anyone's business to tell anyone
else what viewpoints should not be expressed on the netnews.  And one
very good thing about Usenet is that it is very difficult to suppress
unpopular opinions.

I would have no objection to the creation of an "alt.recovery.aa" or
"alt.recovery.12step", which would be intended only for people who are
working AA or other 12-step programs, and in which criticisms of these
programs would be strongly discouraged.  Nor would I object to an
"alt.recovery.theory", which would be intended for discussions of the
principles underlying various recovery methods, their pros and cons,
scientific research on addiction, etc., leaving alt.recovery for
discussions of a more directly practical nature, such as personal
stories of difficulties and successes.  But currently alt.recovery is
the most appropriate forum on Usenet for *all* points of view on
addiction and recovery, including the reasons why AA has helped
millions but is not suitable for all problem drinkers.

Richard