July 23

The Irrationality of Alcoholics Anonymous: A Response

Gabrielle Glazier’s article in The Atlantic, “The Irrationality of Alcoholics Anonymous,” is an interesting read–thought provoking, despite the fact that it contains misrepresentations and misconceptions about AA and a good deal of irrational thought itself. I’ll come back to those points.

Let’s begin by noting the question, stated more than once, that if alcoholism is a disease, why don’t we treat it medically? The answer, obviously, is that medicine has little to offer the true alcoholic. As Glazier notes, alcoholism is a complex set of symptoms. Psychiatry has advanced a great deal since AA was founded in 1935, but it remains basically alchemy. What is known about the workings of the human brain is dwarfed by what is not known. And in practice, psychiatry itself ignores scientific method (and the well-being of the patient) in favor of generalized strategies untailored to the individual and unreliable in the hands of individual practitioners. Some time ago, over a three year period, four professionals diagnosed me with four different psychiatric conditions, each indicating a very different course of treatment. All four were wrong. We must remember that there is no test for chemical imbalance. There is no test for alcoholism.

It is also ironic that at a time when religious people and even scientists are rediscovering the power of prayer for healing, psychiatry is dismissing God as unscientific. Well, yes, it is. But science is beginning to admit that it does not have all the answers, and psychiatry in particular should be at the forefront of that admission.

Glazier notes that there is not a bright line division between alcoholic and nonalcoholic. That is true in a sense. Yet we know from scientific research that there are physical characteristics associated with alcoholism, including changes to liver cells that result in processing alcohol differently, resulting in physical addiction to alcohol. Part of the problem with the article is its fallacy of equating alcohol abuse with alcoholism. Our society has largely adopted this attitude: people who get in trouble because of alcohol are sent to AA by judges, by parents, and by treatment centers. Not all of them are alcoholic. Some may become so, and some are just going through a period of heavy drinking due to negative or positive conditions in their lives. (My brother had to “re-evaluate his drinking habits” while in college; he’s never had a problem since.)

But the main complexity in treating true alcoholics– those who have both the physical addiction and a mental compulsion to drink– is that alcohol is a treatment for an underlying condition. Despite Glazier’s assertion to the contrary, AA well recognizes this fact: “Our liquor was but a symptom. So we had to get down to causes and conditions” (Alcoholics Anonymous, 64). Of the twelve steps, only one of them even mentions alcohol. The others speak of finding a higher power, admitting fault, forgiving others, and setting things right.

The underlying condition of an alcoholic is difficult to identify. When I was drinking, I would have told you I was drinking to kill the pain. But it wasn’t physical pain. It was a deep, psychic pain. I might have told you it was the pain of living. Today, I would characterize it as a deep spiritual dissatisfaction with life that only alcohol (and various other drugs) could relieve. Until I found AA.

Therein lies the problem: Glazier relates that doctors in Finland are using a drug called naltrexone to block the components of alcohol from reaching the receptors in the brain. This would work for a person who drinks for the effect of getting drunk. Why drink if alcohol does nothing for you? But imagine for a moment that alcohol is the only thing you’ve found that makes life bearable. Take it away and life becomes unbearable. Naltrexone makes the alcohol not work. Will you live in agony, or stop taking the blocker? For an alcoholic, the answer is obvious. Absent some other way to ease the pain, we will return to alcohol again and again, regardless of the cost to our health, our families, and our careers.

Glazier, a self-described non-alcoholic, relates that she tried naltrexone and found that her desire to drink diminished. My wife (a recovering alcoholic thanks to AA) relates that to trying my prostate medication to see if it makes a difference. Absent the mental and physical addiction to alcohol, which non-alcoholics can’t grasp, an experiment like that is meaningless. Can Glazier imagine wanting a drink so badly that she would leave her baby alone in a crib while she went to a bar or liquor store, or drive drunk with her child in the car? So badly that she would drink the night before she was scheduled for a court-ordered urinalysis test to verify she was still sober? So badly that she’d drink even while taking antabuse, which would make her vomit violently and uncontrollably when she did so? So badly that, like my uncle, she would drink even if her liver had failed and the doctor told her that one drink would kill her? I seriously doubt it. I wonder of she can imagine the efficacy of naltrexone in those situations?

How can this underlying pain of an alcoholic be addressed? Carl Jung said a massive psychic change was required. AA suggests a spiritual experience. Buddhist practitioners have had success with intensive meditation. There’s been some success with Cognitive Behavioral Therapy (CBT). But in general, psychology and psychiatry have little to offer. Psychology too often fails because alcoholics themselves do not tell the truth. We fear giving up the only thing that makes life bearable, and we lie and obfuscate to ensure that doesn’t happen. Psychiatry fails because, well, it’s a science only when compared with astrology. They don’t know why an alcoholic is so maladjusted to life. How can you fix something when you don’t understand its cause?

AA offers a simple (but not easy) approach that creates a spiritual experience in the practitioner. Yes, it works. I’ve been sober 32 years. But does it work for everyone? Obviously not.

As an aside, I’ll be the first to admit that AA is difficult for atheists. I was an agnostic when I got sober, and that was a challenge. The difficulty for atheists is obvious if you go to a meeting in Buddhist countries like Sri Lanka or Thailand: there aren’t many sober Buddhists. Using AA as an atheist can be done. I’ve known atheists who have. (They often don’t remain atheists, though; the spiritual power of the process eventually causes them to acknowledge faith in God, though it may take years. I myself, formerly agnostic, am now a seminary student.) But I agree that AA is not necessarily for everyone.

Here we run into one of the first misconceptions about AA: the claim cited in the article, originally made in the 1955 version of the book Alcoholics Anonymous, that 75% of the people who came to AA stopped drinking. That number is now closer to 5-8%. But that’s not what the original claim says.

“Of alcoholics who came to A.A. and really tried, 50% got sober at once and remained that way, and 25% sobered up after some relapses…” (Alcoholics Anonymous, xx, emphasis added)

Two things are of note: first, they were dealing with alcoholics, not problem drinkers. Oldtimers who got sober in the 1950s told me that back then, hospitals wouldn’t take an alcoholic, and health insurance wouldn’t cover their treatment. People detoxing would often go into seizures in a meeting, and no one called an ambulance because it wouldn’t come. The social stigma against alcoholism was so strong at that time that you had to be pretty far gone to go to AA. You just didn’t see the casual DUI driver or tippling college student in meetings.

The second point is the phrase “really tried.” The Twelve Steps are not rocket science. AA wisdom says that no one is too dumb to work them but some of us are too smart. They demand a level of honesty and willingness that most people just can’t muster. They demand a level of commitment that comes from the certainty that there is no other possible way to survive. The dying alcoholic is a good candidate for this program. The DUI driver trying to stay out of jail or the binge-drinking college student trying to please his or her parents is not.

As more and more sources send drinkers to AA, the proportion of alcoholics who are willing to “really try” drops. Obviously, so does the success rate. What is AA’s success rate among “true” alcoholics? No one knows, because there’s no effective way to measure them. It’s an anonymous program, after all. Clearly it’s higher than 5-8%, but no one knows how many of the people being sent to AA are actually alcoholics.

It is also noteworthy that not all step-based recovery centers take the steps seriously. During my bout with mental illness, I attended one that had patients read the first three steps while undergoing therapies, CBT, and various other activities. We didn’t actually work the steps. Meetings were optional. Perhaps it was coincidental that many of my fellow patients were there for the second or third time.

Here’s one of the more frightening things I read in the article: the statistic that some 22% of those treated for alcohol dependency could return to moderate drinking. I’m not against drinking–for the nonalcoholic. But for the alcoholic, the risk is so great, why would I take a 4 out of 5 chance that I can’t  drink moderately? I’ve been told by certain ministers that if I’ve accepted Christ into my life, I can drink socially. Maybe so. But if they’re wrong, I would lose my career, my family, and probably my life. Why would I even try? That’s irrational.

Herein lies another irrationality in the thinking behind the article: that drinking is normal, and that normal is good. That idea alone drives many who struggle with alcohol back to the bottle. We desperately want to be “normal.” The truth is, from the time I first got drunk at age 16, I never wanted to just “have a drink with dinner.” I wanted to get as drunk as I could as often as I could. Yes, I’d lie to you, both about how much I wanted and how much I’d had. But honestly, I wanted to be shitfaced drunk as much of the time as I could. Periods of sobriety were miserable. (They usually lasted about ten hours while I went to work.) Why would I think that even after 32 years sober, it would be any different? More to the point, why would I take the chance? That would be irrational.

This thinking also blurs the lines between those who struggle drinking responsibly for whatever reason, and those who are alcoholic. That line can indeed be blurred, as some of the former work their way along the spectrum into the letter category. But by failing to distinguish between those who truly have an addiction and those whose drinking habits we just don’t approve of, we do both a disservice.

Glazier highlights one fact that is undeniably true: abstinence alone will not work in the treatment of alcoholism. An untreated alcoholic will crave that which gives him or her relief until he or she eventually gives in and drinks again.

Let’s put this another way: unlike the problem drinker, alcohol is not the problem for an alcoholic, it’s the self-prescribed treatment of the problem. The problem is far deeper, and is as yet unidentified by science.

Something has to change if an alcoholic is to get sober. This article, while trumpeting the scientific method, highlights that science has so far failed in the treatment of alcoholism. In the absence of real answers (or even real understanding) from the psychiatric community, and with the increasing respect for the role of God in healing, why take aim at AA? It’s not the only answer, but it has gotten million of alcoholics like me sober.

Surely that’s a good thing.

May 2

Fusion, the Future, and Us

Tokamak Energy in the UK has reportedly successfully tested a fusion reactor. That puts it on schedule to provide electricity generated from fusion to the grid by 2030, 13 years from now.

For those who don’t know, fusion is a clean source of energy that works (much like the sun) by fusing hydrogen atoms into helium. It produces no radiation or pollution, and requires only hydrogen, the most abundant element, as a fuel. No mining, no drilling, no dumping.

How abundant is hydrogen?

The two most common elements in the universe are hydrogen and stupidity. (Harlan Ellison)

Which brings up my next point:

We live in a world in which Scotland gets almost all its electricity from wind, in which Germany (hardly a sunny locale) produces so much renewable energy that some days it pays its customers to use electricity, and in which traditionally-conservative China is installing one wind turbine and a soccer-field-sized area of solar panels every hour. Renewable energy is the future, and fusion will eventually lead the way.

Where is the United States in this race to the future?

Unfortunately, we’re stuck in the past, building pipelines, drilling new oil wells, and lifting restrictions on coal companies.

What do you suppose will happen when the global fossil fuel industry collapses due to lack of demand? Economies that rely on oil will collapse with them. Those who work in oil will find themselves suddenly (but predictably) unemployed. Civil unrest will likely result. The Middle East will lose most of its income.

And, barring a future-oriented approach, we’ll be in trouble.

We don’t have a future-oriented approach. We have a short-term, profit-maximizing approach. But don’t worry: the invisible hand of the market will correct that in time. The market abhors outdated technology. And it’s merciless in its judgment. The market will correct us, but that doesn’t mean it will be pretty. How many companies still exist that failed to keep up with emerging technology? Not many.

The sad thing is, it didn’t have to be this way.

Back in the early 1980s, I was a dispatcher at an industrial gas company. We delivered liquid helium, used to supercool other materials, to a secret lab at a local government-funded facility. Our truck driver said they had some crazy idea that they could turn liquid hydrogen into helium and generate electricity doing it. They worked on it for several years. Then they started using enormous amounts of liquid helium. One day, the driver told us that whatever they were building, they had it working. (He had no idea what fusion was.) Two weeks later, the Reagan administration cut the funding and the project was closed down, never to be heard from again.

Why would our government shut down a project that produced cheap, clean energy? The more elucidating question is, who benefited from shutting it down? Instead of fusion, we got 30 years of fossil fuel domination, 30 years of CO2 emissions, 30 years of drilling, mining, spills, and pollution– and 30 years that included record oil company profits, heavily subsidized by tax breaks that shift the burden of paying for our government to us, the taxpayers.

Now England is developing fusion, and it looks like we’ll be left behind.

When will we start running our government with the future in mind?

I’m not holding my breath.

April 2

Bones

There are bones everywhere. Can you see them?

I see the bones of a 17-year-old girl who overdosed last week in Massachusetts. I see the bones of the lonely man who picked up a gun– and the bones of his victims. I see the bones of the suicides, and the mentally ill. I see the bones of Ammon Bundy and Mark Baumer. I see the bones of those who could not afford health care, and still can’t.

I see the bones of men and women who fought for our leaders– but for what?

I see the bones of Michael Sharp, and of Patrice Lamumba.

We are surrounded by bones. Can you see them?

I see the bones of Lazarus spread across a valley. “I am the Resurrection,” Jesus said– and Lazarus breathed again.

How long will we be a people of death?

“I am the life,” said Jesus.

When will we listen?

My God is a God of life. He stretches out his arm to us, and we slap it away.

When will we learn that greed is death, selfishness is death, and isolation is death? Let those who have ears listen! But we do not listen. The cries are too loud–in the cities, in the rural places, in the nations who plead with us for justice.

A thousand channels is not freedom. A thousand restaurants is not prosperity. The best doctor is not health. A broken dream is not life. The body is not the soul.

There are bones everywhere. When will we preach the breath of life?

February 28

John Winthrop, American Prophet

https://i0.wp.com/upload.wikimedia.org/wikipedia/commons/thumb/a/a2/JohnWinthropColorPortrait.jpg/220px-JohnWinthropColorPortrait.jpg?resize=220%2C265&ssl=1
https://upload.wikimedia.org/wikipedia/commons/thumb/a/a2/JohnWinthropColorPortrait.jpg/220px-JohnWinthropColorPortrait.jpg

“Beloved, there is now set before us life and death, good and evil,” in that we are commanded this day to love the Lord our God, and to love one another, to walk in his ways and to keep his Commandments and his ordinance and his laws, and the articles of our Covenant with Him, that we may live and be multiplied, and that the Lord our God may bless us in the land whither we go to possess it. But if our hearts shall turn away, so that we will not obey, but shall be seduced, and worship other Gods, our pleasure and profits, and serve them; it is propounded unto us this day, we shall surely perish out of the good land whither we pass over this vast sea to possess it.

Therefore let us choose life,

that we and our seed may live,

by obeying His voice and cleaving to Him,

for He is our life and our prosperity..

John Winthrop, Governor of the Massachusetts Bay Colony, wrote these prophetic words in 1630. We may not know who he is, but we feel his influence in our culture every day. He’s the one who wrote (in the same document):

“We shall be as a city upon a hill, the eyes of all people are upon us.”

It was Winthrop who instilled in us the idea that we are God’s chosen people.

But as his words above indicate, he also recognized that we faced the same dangers as the Israelites. Just because we were (in his view) chosen did not mean we were automatically good. He warned of worshiping and serving other gods, namely pleasure and profits.

Here we are in the 21st century, nearly 400 years after Winthrop wrote. Our national religion is capitalism. We rank ourselves by our income and our wealth. We shame the poor for not working hard enough. Our heroes are not martyrs or saints, but wealthy people: politicians, businesspeople, movie stars, and sports figures. Yet, at the same time, real economic advancement is more difficult than ever, and the percentage of people living in poverty is greater than at any time since 1965. Some 32% of those living in poverty have jobs. Yet we continue to cut taxes and complain about the burden of the poor, while the tax revenue we do collect goes overwhelmingly to the military.

I don’t think that’s what Winthrop had in mind. Take, for example, this except:

Question: What rule shall a man observe in giving in respect of the measure?

Answer: If the time and occasion be ordinary he is to give out of his abundance. Let him lay aside as God hath blessed him. If the time and occasion be extraordinary, he must be ruled by them; taking this withal, that then a man cannot likely do too much, especially if he may leave himself and his family under probable means of comfortable subsistence.

In other words, in ordinary times, we are to share our abundance freely with others, but not to the extent that he jeopardizes his family’s “comfortable subsistence.” In extraordinary times, we must do more, ruled by the need of others and not by our own needs. “A man cannot likely do too much.”

Winthrop’s position was based in the Bible, but his emphasis on charity stemmed from very pragmatic concerns: he saw that extreme divisions in wealth caused a destructive division in society. Those who were wealthy tended to look down on the poor, and the poor tended to resent the rich.

Fast forward to today: That’s pretty much what has happened.

In Winthrop’s day, and for the next 200 years, towns gave fuel, food, and money to their poor. It wasn’t until the 1850s that hundreds of thousands of refugees from the Potato Famine in Ireland overwhelmed this system, and states became more involved. And yes, the Irish were hated just as much then as Muslims are today. Yet few would look back now and argue that we shouldn’t have helped them.

Now we live in a world in which half the population lives on $8 a day or less. Compare that to the median income of $75 per day per person for Americans. (Yes, this is adjusted to reflect pricing differences between countries, giving an “apples-to-apples” comparison.) No longer do the poor in America look like the poor everywhere else, in eorther numbers of quality of life, as they did in Winthrop’s day. We are the wealthy. What are we going to do about it?

If Winthrop was right, we have a covenant that calls for charity. Otherwise, we will lose this land.

February 25

Oh Proud Nation!

The Word came to me again:

Look at the proud nation! How they go here and there without a thought for those they trample underfoot. “I did this,” they say. “I made these riches.” Oh, you wicked, arrogant people, have you no shame? What you have, you were given by your Lord, or else you took from someone else. You have made nothing! You are but the image of the One that is, and even that you have forgotten! My son gave his life for you to save you from sin and even death. What do you give in return? You shield your eyes from the poor, call them criminals, and blame them for their poverty.

Hear this, oh proud nation: I do not know you! For you have strayed far from my teachings, and look only upon yourselves. You cry “Lord, Lord,” but you say it as if into a mirror. Save yourselves, then, if you think you can! Send forth your mighty armies, your riches, your bankers, and your politicians. See how they fare! Beat your brows upon the cliffs of the sea until you return to your senses, or until you drown.

Rebellious children, you do not hear the language of love. Listen then to the language of consequence. You will reap as you have sown. Your fields shall burst forth with weeds and thistles—eat them! Your cup will be of poisoned water—drink it. And your mattress shall be hard with the bones of those you have trodden in your quest for riches. See then how you sleep.

When you have had enough, when you are ready to hear, turn then back to me, for I have not yet given up my love for you. But know this: it is not I who punish you, but you who punish yourselves. No longer will I shield you, for you have become spoiled children who do not learn.