Moderated: Why do people insist AA is not religious?/Efficacy of AA & other treatment programs

[Hallo Alfie]

Originally Posted by Bamberger

The heavy use of the word God in both AA literature and in prayers at meetings makes it religious.

Which has been explained here ad nauseum. The big book itself outlines that god mean spiritual and that spiritual can be whatever you want it to be. (page 43 if memory serves).

"When, therefore, we speak to you of God, we mean your own conception of God. This applies, too, to other spiritual expressions which you find in this book."

What are these other spiritual expressions do you suppose?
That's right, anything you want.

Originally Posted by Bamberger

Evidence, please

See just a few posts up - there is a peer reviewed study for your edification.

Originally Posted by Bamberger

Evidence, please.

I am waiting on the efficacy of other modalities myself. The anti-AAers insist there are "science" and/or "evidence based therapies", sadly they have yet to stump up with any actual evidence.

In terms of these working better with AA, please refer to the study cited.

End thread.

[oody]

Originally Posted by A.A. Alfie

I am waiting on some to comments on this science based research:

http://www.ncbi.nlm.nih.gov/pubmed/16696626

Could be some interesting correlations possibly with accompanying causation, or possibly evidence of group activity in general being beneficial.

I have been unable to get a full copy without apparently having to buy a subscription. Do you have further information on where I can see this article, and not just the abstract? Or shall I start asking them for for prices?

[The Norseman]

Originally Posted by Minoosh

The semi-snotty answer is, I can't believe you have to ask. The straight answer is, my experience, other people's experiences, observation, reading, being in treatment, talking to experts, etc. I've been studying this for more than 30 years.

The stuff I say is pretty much medical consensus.

Pretty much? How about just remaining mute on the subject because it's not your call to make giving this kind of advice to a high-risk population?

[Hallo Alfie]

Originally Posted by oody

Could be some interesting correlations possibly with accompanying causation, or possibly evidence of group activity in general being beneficial.

There could be a lot of things in there. I would speculate that none of it would change the very specific mention of AA - twice - in their conclusions. You are tossing around some interesting speculation here that is unlikely in the extreme.

Originally Posted by oody

I have been unable to get a full copy without apparently having to buy a subscription. Do you have further information on where I can see this article, and not just the abstract? Or shall I start asking them for for prices?

Norseman may have more - he provided it to us (my gratitude knows no bounds) and I have what you have.

What we have is confirmation (of my early claims) that people have a better chance at staying sober with AA than without. That as a maintenance program used in conjunction with other therapies (detox and rehab) people have twice the chance of recovery than those who do not use it.

Peer reviewed too.

[Hallo Alfie]

Originally Posted by The Norseman

Pretty much? How about just remaining mute on the subject because it's not your call to make giving this kind of advice to a high-risk population?

There is a difference between advice and an opinion.

[The Norseman]

Originally Posted by A.A. Alfie

I am waiting on some to comments on this science based research:

http://www.ncbi.nlm.nih.gov/pubmed/16696626

Estimating the effect of help-seeking on achieving recovery from alcohol dependence

This confirms some of what I have been saying for a long time that recovery is a three stage process: detox, rehab and maintenance.

“Individuals who participated in 12-Step programs in addition to formal treatment had almost twice the chance of recovery and more than more than twice the chance of AR compared with those who received formal treatment alone.”

CONCLUSIONS:

“Help-seeking plays a significant role in the achievement of abstinent recovery from alcohol dependence, with 12-Step participation playing a major role. Appropriate model selection is critical to assessing the impact of help-seeking.”

Well I'll be stuffed!
One has twice as much chance of maintaining sobriety using 12 step fellowships that without.

I would also challenge C&E, Joey etc to provide this information to the hate group they love - given that they want to help people to get sober and all that.

As I've already said, Alfie, this study shows that attending some groups may be helpful. What is not shown, however, is that the AA program has anything to do with it. This study conflates self-help groups in general with AA specifically. A study needs to be done comparing AA with other groups and if AA shows a statistically significant level higher then the comparison groups, ONLY THEN can you crow about how effective AA is. Until then, you should be telling your clients to get out and go do something with a group, like hiking or photography or SOS because it's all just as helpful. If a person wants a good dose of The Big Guy up in heaven, tell them to go to church; if they want spirituality, they can join the Universalists. No one specifically needs AA.

Quote:

I think the answers we sought from the start of the thread have been answered, namely:

Is AA religious? No: It is a spiritual program but it can be (religious) if one wants it to be.
Does AA work? Yes, in conjunction with other treatments (detox and rehab/counselling etc), people have twice as much chance of attaining and maintaining sobriety as they would without.
What is the efficacy of other treatments? Unknown, but they will work better with AA.

End thread.

Is AA religious? Yes: various courts around the US have ruled that it's religious enough to have violated the First Amendment. This happened because attorneys working in an evidence-based assumption was able to show the history, language, and perceptions of AA as being far, far more religious than secular.

Does AA work? No: It has not been shown that the AA program has anything to do with recovery other than what group attendance (with any group) has shown.

What is the efficacy of other treatments? Some are known, some are not, depending.

Originally Posted by A.A. Alfie

Which has been explained here ad nauseum. The big book itself outlines that god mean spiritual and that spiritual can be whatever you want it to be. (page 43 if memory serves).

"When, therefore, we speak to you of God, we mean your own conception of God. This applies, too, to other spiritual expressions which you find in this book."

What are these other spiritual expressions do you suppose?
That's right, anything you want.

And again, how can you possibly say that doing whatever you want with a concept that means anything you want could be even remotely considered a 'program'? How can a program in which you do whatever you feel like be considered more effective than doing nothing? It cannot and actually so far, it's been demonstrated that the AA program is no more effective than doing nothing (or going bowling).

Quote:

See just a few posts up - there is a peer reviewed study for your edification.

Funny how it wasn't you who originally posted that study. Funny how it doesn't quite say what you wish it would say.

Quote:

I am waiting on the efficacy of other modalities myself. The anti-AAers insist there are "science" and/or "evidence based therapies", sadly they have yet to stump up with any actual evidence.

Since AAs have consistently said that AA works and since the null hypothesis is the default, it is presumed that AA isn't more effective than doing nothing. Sadly, AAs have yet to disprove the null hypothesis. Sadly, you had to use evidence-based therapies in scare-quotes because of your insistence, similarly to astrology or homeopathy, that alcoholism is a spiritual disease which is best solved by a spiritual solution (which has no evidence whatsoever to support that contention that Bill W. made up seventy plus years ago and hasn't been changed since).

By the way, those studies I outlined earlier most of which you dismissed as irrelevant are actually quite relevant in that they demonstrate beyond a doubt that the spiritual disease concept of AA is utterly wrong, and because they're wrong, the steps (pardon the pun) taken are actually not aimed at addressing the real causes. In other words, having a chemical imbalance in the brain is not solved by turning one's will and life over to some vague, whatever-you-feel-like-at-the-moment so-called higher power.

Quote:

In terms of these working better with AA, please refer to the study cited.

Inpatient therapy works better with some support mechanisms outside of treatment but you have yet to show that the AA program works better than joining a knitting circle.

Quote:

End thread.

First, this isn't your thread to end and second, why the hurry? Don't wish to talk about other evidence any more? How about taking some time and finding more studies than the ones I presented for discussion?

[The Norseman]

Originally Posted by oody

Could be some interesting correlations possibly with accompanying causation, or possibly evidence of group activity in general being beneficial.

I have been unable to get a full copy without apparently having to buy a subscription. Do you have further information on where I can see this article, and not just the abstract? Or shall I start asking them for for prices?

Just in case you didn't get it, I sent a PM to you. This is one of the papers I was able to d/l and I'd be willing to forward it to you.

[Minoosh]

Originally Posted by Bamberger

Evidence, please

Posted, but easily discounted by the following claim:

Originally Posted by The Norseman

... when other groups produce the same results or other programs give the same amount of self-esteem boosts as AA, it goes to demonstrate that there's nothing unique or special about the AA program itself that's worthy of emulation or support.

All things being equal, I have no quarrel with that statement. But all things aren't equal. AA has thrived while other support groups haven't. Why is that? The service component keeps it free, voluntary, accessible and self-sustaining. It has the best network of free services.

As far as I can tell, AA isn't asking for either "emulation" or "support" - it just keeps plugging along. In the long term, no program or group can really "give" you self-esteem. The steps spell out a program designed to build self-respect. They're not the only route, and there's nothing magic about the number 12. I think of it this way - there are lots of ways to get strong - farming, shoveling snow, chopping wood. It also turns out that if you pick 12 strength exercises and do them to failure 3 times a week, you're practically guaranteed to get stronger.

Is strength training woo? No. However it has some weird features. It works better if you focus your mind on the exercise. One study even found people could get stronger by imagining the exercise. (It was more work than just doing the exercises, though). My point is, it works better when mind and body are engaged. And, for best results you also take control of your breathing. Integrating mind, body and "spirit" optimizes the exercise.

I don't know if AA has absolutely optimized the performance of these 3 elements. I do legitimately see 3 elements. If not "spirit" then mind, body and integrated mind-body. Or, body, conscious mind and subconscious mind. Body, central nervous system, autonomic nervous system. The program got hammered out by a committee that didn't foresee teenage members, a huge influx of young women or new-generation antidepressants and anti-psychotics. I think they did a pretty good job.

Does AA work? Nothing "works" except sufficient motivation. AA attendance can enhance motivation - "bring the body and the mind will follow." Help-seeking is correlated with abstinent recovery. AA is committed to being available 24/7/365, all over the world, for free. We can gas on about the theoretical benefits of theoretical support, but when you reach out, whose hand is actually there?

There's nothing unique about AA, except that it's unique.

[Minoosh]

Originally Posted by The Norseman

Pretty much? How about just remaining mute on the subject because it's not your call to make giving this kind of advice to a high-risk population?

Because doctors don't always think to tell their patients these things and people don't always read the prescribing information. Sometimes, doctors unwittingly get patients hooked on drugs or contribute to ODs.

Taper from benzos unless you're at a very low dose. Don't crush up and snort an OC 80 if you're not used to the dose. If you've been a daily, heavy drinker, don't stop abruptly without someone nearby to monitor your safety. A pre-emptive, short-term course of benzos reduces the risk of convulsions. None of this is controversial, I swear.

[Hallo Alfie]

Originally Posted by The Norseman

As I've already said, Alfie, this study shows that attending some groups may be helpful. What is not shown, however, is that the AA program has anything to do with it.

Actually, it specifically mentions 12 step fellowships, it does not use your nebulous "some groups".

Originally Posted by The Norseman

This study conflates self-help groups in general with AA specifically.

Um. No, not from what I've seen it doesn't. Do you have some evidence of this claim?

Originally Posted by The Norseman

Until then, you should be telling your clients to get out and go do something with a group, like hiking or photography or SOS because it's all just as helpful.

Are you giving a professional professional advice? Isn't that a bit hypocritical when you are telling Minoosh that sponsors (who have no formal qualifications) should not be giving their opinions?

Originally Posted by The Norseman

What is the efficacy of other treatments? Some are known, some are not, depending.

Which ones are known? Can you show us?

Originally Posted by The Norseman

And again, how can you possibly say that doing whatever you want with a concept that means anything you want could be even remotely considered a 'program'? How can a program in which you do whatever you feel like be considered more effective than doing nothing? It cannot and actually so far, it's been demonstrated that the AA program is no more effective than doing nothing (or going bowling).

I didn't mention "program", but "spiritual expression" as being anything you like. This has also been discussed ad nauseum and proven time and again by our atheist AA representatives here.

Originally Posted by The Norseman

Funny how it wasn't you who originally posted that study.

Did you miss where I acknowledged you and thanked you for it on more than one occasion? If you did, thanks again.

Originally Posted by The Norseman

Funny how it doesn't quite say what you wish it would say.

Actually it is you making claims around what it doesn't say, i.e. your nebulous "some groups" nonsense - the conclusions are quite specific in terms of what benefits 12 step fellowships can give: i.e. double the chance of recovery. Double! Can you imagine?

Originally Posted by The Norseman

Since AAs have consistently said that AA works and since the null hypothesis is the default, it is presumed that AA isn't more effective than doing nothing.

Um wrong. In fact you have provided a peer reviewed study that shows this to be wrong.

Originally Posted by The Norseman

Sadly, AAs have yet to disprove the null hypothesis.

Actually it is the responsibility of others to prove the hyposthesis. This has not been done.

Originally Posted by The Norseman

How about taking some time and finding more studies than the ones I presented for discussion?

What for? My beliefs have been confirmed by peer review.

Did I say thanks for that, btw?

[Minoosh]

Originally Posted by The Norseman

A study needs to be done comparing AA with other groups ...Until then, you should be telling your clients to get out and go do something with a group, like hiking or photography or SOS because it's all just as helpful.

OK, it sounds like you're telling Alfie to stop suggesting something that has been proven to help ... and instead refer clients to activities that haven't been proven to help ... because in your mind they should theoretically help. And only when AA has been cross-studied with every conceivable helpful group activity should clients be referred to AA.

I'm a little unclear on the last bit: Exactly how many activities must be studied head-to-head with AA in order to meet your bar of proof? At what point would it be OK for drug counselors to cautiously suggest that AA might help?

Originally Posted by The Norseman

No one specifically needs AA.

No one specifically needs anything that isn't food, water and shelter. And air. I'm sure I'm missing something. But, colloquially speaking we need all kinds of things. Companionship, hope, a sense of usefulness. Some people might need these things in exactly the combination (and with exactly the flexibility and access) that AA offers. I would not presume to say that AA is the only place to get those things, but if people say "I need AA," I believe them. Isn't it really their call, and not yours?

Originally Posted by The Norseman

Does AA work? No: It has not been shown that the AA program has anything to do with recovery other than what group attendance (with any group) has shown.

It has been shown that AA works. It hasn't been shown that AA works better than playing Scrabble at Denny's. If you want to go with what so far has proven effective, AA has Scrabble beat.

Quote:

Since AAs have consistently said that AA works and since the null hypothesis is the default, it is presumed that AA isn't more effective than doing nothing.

Presumed by you, maybe. I'm spotting a flaw in your logic.

[causeandeffect]

Originally Posted by A.A. Alfie

I understood then what I understand now (as would anyone with half a brain), that it was a cynical attempt at a "gotcha!" which failed.

No, it would have failed if you had known the answer to the question. You did not know the answer, so it succeeded, (as anyone with one quarter of a brain would know.)

Quote:

Now, would you care to comment on this peer reviewed study?


http://www.ncbi.nlm.nih.gov/pubmed/16696626

Yes, I would now that the Norseman has had an opportunity to weigh in on it. I agree with his assessment that it didn't compare AA to any other form of help seeking, but I would like to add this;


“In another study based on the self-reports of 125 alcoholism treatment clients, readiness to change predicted abstinence at 12-month follow-up. Moreover pretreatment motivation was related to Alcoholics Anonymous affiliation at follow-up.”


http://www.mendeley.com/research/rea...utcome/#page-1


They were highly motivated even before they set foot in AA. So, you see, many people who attend AA are simply highly motivated and highly motivated people are more likely to seek help. And when highly motivated people seek help, they are naturally going to go to the only place they know--AA. They will do anything to get sober, regardless of how crazy it seems. Those are all the people you see who stay in AA. Others are highly motivated and go to AA, only to find it irrelevant to not drinking, so they leave.


Of course there are highly motivated people who do it on their own as shown by the NESARC.


And this study found no difference in outcome between those who attend AA regularly and those who never attend. No difference whatsoever. The group who fared the worst was the occasional meeting maker. Could it be that the concept of powerlessness badly effected these people instead of what they’ve postulated?


“Pretreatment AA affiliation was not found to influence prognosis significantly. However, an infrequent or irregular pattern of posttreatment AA attendance was associated with a much poorer prognosis than either regular attendance or nonattendance. Success:failure ratios were statistically equivalent for the latter two groups.”


http://www.mendeley.com/research/alc...blem-drinkers/



And this meta-analysis shows that brief interventions are just as good as extended treatment. It looks like rehab is just a huge waste of money for most people. Again, it’s a matter of motivation.



"Most investigations fell into one of two types: those comparing brief interventions with control conditions in non-treatment-seeking samples (n = 34) and those comparing brief interventions with extended treatment in treatment-seeking samples (n = 20). For studies of the first type, small to medium aggregate effect sizes in favor of brief interventions emerged across different follow-up points. At follow-up after >3–6 months, the effect for brief interventions compared to control conditions was significantly larger when individuals with more severe alcohol problems were excluded. For studies of the second type, the effect sizes were largely not significantly different from zero. This review summarizes additional positive evidence for brief interventions compared to control conditions typically delivered by health-care professionals to non-treatment-seeking samples. The results concur with previous reviews that found little difference between brief and extended treatment conditions.”


http://www.ncbi.nlm.nih.gov/pubmed/11964101



Nothing shows AA to have any particular inherent value in treatment. All that is shown is that many (not all) motivated people seek help. Those are the same people you see in meetings saying AA saved their life. They would have probably tried biting their own toenails if they found a group of people that swore that it would end their drinking. Actually they saved their own lives. The steps, sponsors, the AA God, the AA religion or any other aspect of superstitious faith healing were completely superfluous.

[causeandeffect]

Originally Posted by A.A. Alfie

"When, therefore, we speak to you of God, we mean your own conception of God. This applies, too, to other spiritual expressions which you find in this book."

What are these other spiritual expressions do you suppose?
That's right, anything you want.

So what? All that means is that you can call a bedpan your God and it’s OK as long as you have a God. That must make it the strangest cult ever.

There are 335 mentions of the word God in the big book. That doesn’t include other references such as “Him” or “His.”

http://www.recoveryemporium.com/Big%...ance%20GHI.htm

There are another 173 in the 12&12:

http://www.recoveryemporium.com/12%2...rd%20DEFGH.htm

That’s 508 times in two small books.

“Everybody hold hands now….Our Bedpan who art in heaven….hallowed be thy name…”

As a side note, the big book was called so because Bill Wilson chose to have it printed on extra thick paper, to fluff it and make it look bigger and more impressive than it really is.

[causeandeffect]

Originally Posted by Minoosh

I exaggerated the "Brian" exchange for what I thought were good reasons, but really, it stemmed from inflated self-importance.

Hmmm, I really don’t buy that negative label. I think it’s more that you’re protective of that which you love, which is a positive characteristic. It’s great in parents, but also in other familial relationships, friendships as well as employment. I also think you were feeling a high degree of frustration in doing so, and made a mistake. To err is human.

Quote:

I'm more or less immune to slogans and don't interpret the language of the steps in a negative way.

What about those who interpret the language in a literal way? And what about when it has a negative effect on them?

Quote:

For example the idea of "losing myself" was never a threat. Have you ever sought out a friend, ready to "vent," only to realize they need it more than you? Like, I'm on the verge of bitching about something minor - then learn my friend has just had to put down a beloved pet. Instantly I'm there for my friend and grateful I didn't launch into my rant. It feels something like being "rocketed into a fourth dimension." Big Book corn with a kernel of truth.

I would consider this more along the lines of being a good friend. And in order to give credit to AA for this, you must come from the position that you by nature are so self-absorbed that you are a bad friend and only AA taught you how to be a good friend who listens--which I seriously doubt. Empathy and caring are a normal part of human nature, (well, not everybody has it but I believe most people do) and above all we are humans. It used to irk me to no end to hear people giving credit for normal human decency to the program, when the credit was due to the individual. This is what I mean about being in a negative relationship with your self. And it seemed to always be the nice people who soaked up these negative messages like a sponge. The arrogant ones never seemed to take it in and just remained arrogant.

Quote:

If not "spirit" then mind, body and integrated mind-body. Or, body, conscious mind and subconscious mind. Body, central nervous system, autonomic nervous system.

Do you mind expanding on how AA integrates mind and body? And the autonomic nervous system?

Quote:

Nothing "works" except sufficient motivation.

Exactly. But I would argue that the act of voluntarily going to AA shows motivation in and of itself, however, there are techniques that have been developed and are still developing to enhance motivation. It does, however, require some specific training, and some personalities are not well suited for it. Some personalities naturally have the opposite effect whether they used the techniques or not.

[Minoosh]

Originally Posted by The Norseman

Does AA work? No: It has not been shown that the AA program has anything to do with recovery other than what group attendance (with any group) has shown.

If a study showed aspirin worked for headaches, and you had a headache, would you turn down aspirin whilst you waited for scientists to study acetaminophen?

If a study showed that aspirin, acetaminophen and ibuprofen all worked equally well, you'd have a choice, and your decision could be based on lots of things.

Originally Posted by The Norseman

... So far, it's been demonstrated that the AA program is no more effective than doing nothing (or going bowling).

I don't agree with the "doing nothing" part. Studies have found that help-seeking is strongly correlated with recovery. We could try to determine whether asking for help enhances recovery, or whether people seeking help are inherently more motivated to recover. In a way it doesn't matter. Just go to a recovery meeting and there's a good chance you'll get a motivational boost. It becomes a feedback loop. A key feature is identification. At least, it is for a lot of people. Besides, everyone knows that idle hands are the devil's workshop

As far as the bowling part: It seems to me you've set an impossibly high standard. If you have a headache, are you going to hold off taking aspirin until it's been proven that aspirin works better than going bowling? Or joining a sewing circle, or any other conceivable activity?

Originally Posted by The Norseman

By the way, those studies I outlined ... are actually quite relevant in that they demonstrate beyond a doubt that the spiritual disease concept of AA is utterly wrong ... In other words, having a chemical imbalance in the brain is not solved by turning one's will and life over to some vague, whatever-you-feel-like-at-the-moment so-called higher power ...

I wouldn't write off the concept that quickly. Even if Joey's right - if AA just provides fake serenity to hold you over while the brain heals - it's difficult to assess the baseline chemical imbalance if you're drinking heavily. Drinking itself causes a chemical imbalance. Suborning faith actually makes sense. For one thing, plenty of people won't find it a huge reach to believe in a power greater than themselves.

Do you believe in magic
in a young girl's heart
how the music can free her
whenever it starts ...

I'll tell ya about the magic
It'll free your soul
but it's like trying to tell a stranger 'bout rock 'n roll ...

*all the magic's in the music and the music's in me*

I had a near-spiritual experience around Jimi Hendrix. We were in the treatment van, going to a meeting. One person liked country, one couldn't listen to lottery commercials, one wanted soft rock ... the driver kept pushing buttons. "Hey Joe" came on and we all said in unison, "Leave it!" Something about that song reached every one of us and we cracked up laughing. All of a sudden I realized I was enjoying myself while in acute withdrawal. Was it the song, the laughter, the camaraderie? The combination? Anyway, some good brain chemicals were squirting out. I felt better. A non-material factor triggered a material change in my brain chemistry. Happens all the time - my body transmits sensory information to my brain and the dopamine kicks in. The mind-body experience is yet more powerful for being shared.

Overusing drugs for pleasure can really mess up those reward circuits.

Another long post replying to something that's none of my business.

[Minoosh]

Originally Posted by A.A. Alfie

I didn't mention "program", but "spiritual expression" as being anything you like.

Part of the point with any "program" is that you're not improvising from moment to moment. As in "exercise program" - you make a commitment to do it, whether you feel like it or not.

For 6 months I had to schedule my days down to the minute and get my schedule approved by a probation officer. It worked great. The point is my time was "programmed." It didn't matter if I felt like a meeting; if it was on my schedule I went. For some reason I found this immensely helpful, and, paradoxically, liberating. Less angst.

Yesterday I went to a meeting, the first in months. It felt good. I've just cut the suboxone by 1/3 and am starting to crave that sort of structure again. It keeps anxiety at bay. I know you're not my drug counselor but I am hereby committed to attending today. >

Originally Posted by A.A. Alfie

Actually it is you making claims around what it doesn't say, i.e. your nebulous "some groups" nonsense - the conclusions are quite specific in terms of what benefits 12 step fellowships can give: i.e. double the chance of recovery. Double! Can you imagine?

Norseman's core claim is technically true. AA hasn't been studied head-to-head with bowling, or playing footie or a virtually infinite number of other activities. So "AA has not been proven to work better than playing footie" is factually true. The logic doesn't extend to, "It's been proven AA is no better than playing footie."

Originally Posted by A.A. Alfie

Actually it is the responsibility of others to prove the hyposthesis. This has not been done.

Really? I don't know much about formal logic. There was a study that randomly assigned probationers to one of 3 types of groups. As I recall that study showed no advantage in AA. Every study has its limits and this one was limited to people on probation. Similarly the VA concluded that naltrexone was no better than placebo for chronic alcoholics in their sixties. I guess my point is, studies have limited parameters, so it's important to pay attention to the details - what the researchers are actually trying to measure.

[Hallo Alfie]

Originally Posted by causeandeffect

So what? All that means is that you can call a bedpan your God and it’s OK as long as you have a God. That must make it the strangest cult ever.

There are 335 mentions of the word God in the big book. That doesn’t include other references such as “Him” or “His.”

There are another 173 in the 12&12:

That’s 508 times in two small books.

You are very good at counting aren't you. Yet my question to you remains unanswered:

"When, therefore, we speak to you of God, we mean your own conception of God. This applies, too, to other spiritual expressions which you find in this book."

What are these "other spiritual expressions" do you think?


This little citation I am pointing out covers all uses of the word "god" in the big book and elsewhere: "When we speak of god, we mean "....
Really, it's not that had to understand is it?

In other words, the word "god" is a catchall for anything one wants, any form of expression, any god, any philosophy, anything. If you want to use a bedpan, a doorknob or a spaghetti monster, knock yourself out. It wouldn't work for me, but who am I to judge your form of spiritual expression?


Your earlier comments on this study lack any substance:

http://www.ncbi.nlm.nih.gov/pubmed/16696626

Estimating the effect of help-seeking on achieving recovery from alcohol dependence

This confirms some of what I have been saying for a long time that recovery is a three stage process: detox, rehab and maintenance.

“Individuals who participated in 12-Step programs in addition to formal treatment had almost twice the chance of recovery and more than more than twice the chance of AR compared with those who received formal treatment alone.”

CONCLUSIONS:

“Help-seeking plays a significant role in the achievement of abstinent recovery from alcohol dependence, with 12-Step participation playing a major role. Appropriate model selection is critical to assessing the impact of help-seeking.”


You have stated that you agree with Noreseman's assessment on this, however his assessment - and your support for same - is actually devoid of evidence.

So rather than dismiss this out of hand, please show me how you arrived at the conclusions you did.


Can I also ask whether you will be providing this study that Norseman so kindly provided to the hate group of Stinkin' Thinkin'? Seeing as they want to help alcoholics, surely this information would be important. It is "science and evidence based", and peer reviewed after all.

[Minoosh]

Originally Posted by causeandeffect

They were highly motivated even before they set foot in AA. So, you see, many people who attend AA are simply highly motivated and highly motivated people are more likely to seek help. And when highly motivated people seek help, they are naturally going to go to the only place they know--AA.

If they're that highly motivated, wouldn't they be motivated to do a little research?

Originally Posted by causeandeffect

The group who fared the worst was the occasional meeting maker. Could it be that the concept of powerlessness badly effected these people instead of what they’ve postulated?

Conversely I wonder how many people have been positively effected by the concept of powerlessness.

Originally Posted by causeandeffect

... an infrequent or irregular pattern of posttreatment AA attendance was associated with a much poorer prognosis than either regular attendance or nonattendance.

That is interesting, and helpful. Also intuitive: People who can stay abstinent without a support group do so. Others of us find we do better with a support group, and make a commitment to regular attendance. The occasional attenders are voting with their feet and demonstrating that they're not making a commitment to either doing it on their own or admitting they need help.

Originally Posted by causeandeffect

And this meta-analysis shows that brief interventions are just as good as extended treatment. It looks like rehab is just a huge waste of money for most people.

Which is probably why insurance quit paying for it. But, it wasn't a waste of time for me. Even though I used short-acting narcotics again afterward, I never got up to the previous level. So when the probation officer told me to drop and I told her I couldn't, I was in a position to stop 40 mg a day of hydrocodone cold turkey. Weaning from 120 mg of methadone in 21 days? I very seriously doubt I could have done that as an outpatient. As a matter of fact the clinic flatly told me, "it won't work" when I proposed doing it again - as an outpatient - more than a decade later. Talk about negative messages getting lodged in the brain!

Originally Posted by causeandeffect

Again, it's a matter of motivation.

But what causes motivation? The downside of my current, stable dependence is much smaller than the kamikaze driving-while-unconscious days. The only problem is, I don't want to be on controlled substances for the rest of my life, and I suspect they are contributing to chronic depression. By taking Xanax at bedtime I obviate the need to be physically tired in order to sleep. Yuck, spiral. But my docs said I should spend a year on suboxone and I should quit the suboxone before quitting Xanax.

Yesterday I went to a meeting and felt a lot better. One of the studies you cite is encouraging me to go to another today. Besides I told Alfie I would. It's cold, I'm having a bad hair month, it's easier to stay home. But I know it will enhance my own motivation.

Actually I'm more worried about my obsession to post here than I am about the substance regime. That's what really got me out the door.

Originally Posted by causeandeffect

Actually they saved their own lives. The steps, sponsors, the AA God, the AA religion or any other aspect of superstitious faith healing were completely superfluous.

It wasn't superfluous for them. It takes what it takes. People who go to AA get lots of different things out of it. It was the bright spot in my day yesterday, and just about the only group activity I would have been willing to participate in, for complicated personal reasons.

[Hallo Alfie]

Originally Posted by causeandeffect

No, it would have failed if you had known the answer to the question. You did not know the answer, so it succeeded, (as anyone with one quarter of a brain would know.)

Edited by Tricky:

Edited for moderated thread.

Originally Posted by causeandeffect

“In another study based on the self-reports of 125 alcoholism treatment clients, readiness to change predicted abstinence at 12-month follow-up. Moreover pretreatment motivation was related to Alcoholics Anonymous affiliation at follow-up.”

http://www.mendeley.com/research/rea...utcome/#page-1

You are talking motivation here, not treatment. I may be missing something but I'm honestly not sure what you are trying to show us.


Next: This study states:

http://www.mendeley.com/research/alc...blem-drinkers/

However, an infrequent or irregular pattern of posttreatment AA attendance was associated with a much poorer prognosis than either regular attendance or nonattendance.

In other words, regular and frequent AA attendance provided a better prognosis.

Thanks for this one.

Originally Posted by causeandeffect

And this study found no difference in outcome between those who attend AA regularly and those who never attend. No difference whatsoever. The group who fared the worst was the occasional meeting maker. Could it be that the concept of powerlessness badly effected these people instead of what they’ve postulated?

Are we reading the same thing? It says no such thing.

Originally Posted by causeandeffect

And this meta-analysis shows that brief interventions are just as good as extended treatment. It looks like rehab is just a huge waste of money for most people. Again, it’s a matter of motivation.

Wrong again - the highlighted bit gives an indication as to why.

"Most investigations fell into one of two types: those comparing brief interventions with control conditions in non-treatment-seeking samples (n = 34) and those comparing brief interventions with extended treatment in treatment-seeking samples (n = 20).

For studies of the first type, small to medium aggregate effect sizes in favor of brief interventions emerged across different follow-up points. At follow-up after >3–6 months, the effect for brief interventions compared to control conditions was significantly larger when individuals with more severe alcohol problems were excluded.

For studies of the second type, the effect sizes were largely not significantly different from zero. This review summarizes additional positive evidence for brief interventions compared to control conditions typically delivered by health-care professionals to non-treatment-seeking samples. The results concur with previous reviews that found little difference between brief and extended treatment conditions.”

http://www.ncbi.nlm.nih.gov/pubmed/11964101 [/quote]

The second part confirms also what I have been saying and does not refute the other study; it does not take into consideration the third part of recovery, i.e. maintenance. This study looks at one aspect only, AA (as a form of maintenance) is part of a three phase recovery which has been my contention since the outset. The three phases are detox, rehab and maintenance.

Originally Posted by causeandeffect

Nothing shows AA to have any particular inherent value in treatment.

Nope, wrong. Fail.

[AlBell]

Originally Posted by Minoosh

....

I'm spotting a flaw in your logic.

I suspect norseman remains hung-up on 'spirituality' and/or 'god-as-you-understand-him'.

[Bamberger]

Originally Posted by causeandeffect

There are 335 mentions of the word God in the big book. That doesn’t include other references such as “Him” or “His.”

There are another 173 in the 12&12:

That’s 508 times in two small books.

That's a whole lotta God, I'd say. Also, percentage-wise how many meetings worldwide do you think either begin and/or end with the Lord's Prayer or Serenity Prayer? Let's say it's > 90%. Just a guess, but let's say it's about that. Does this mean that the individual members collectively agree to utilize such prayers? I would say yes, assuming that groups truly are autonomous.

This would then mean that the members are willingly using Christian prayers based on their personal beliefs in a Christian God. Christianity is a religion, albeit one with many sects and denominations. Is AA just another religious sect? Yes, I would say so.

[Minoosh]

Originally Posted by causeandeffect

Hmmm, I really don’t buy that negative label. I think it’s more that you’re protective of that which you love, which is a positive characteristic.

That's nice. Thanks. However in my scheme it's helpful to note what's behind an error. What I love is more or less involuntary; right-sizing my ego falls under things I might be able to change. If I do the right thing for the wrong reason, no problem. If I do the wrong thing for the right reason, nope, doesn't work: The outcome is wrong.

Originally Posted by causeandeffect

What about those who interpret the language in a literal way? And what about when it has a negative effect on them?

Easy does it? Live and let live? How do you protect anyone that literal from any stray phrase that enters their heads? The "powerless" term didn't mean much to me until I realized that I could use on Thursday night but I'd have to stop Friday. I didn't know if I could do it. The phrase became meaningful when it matched the internal state.

Originally Posted by causeandeffect

... in order to give credit to AA for this, you must come from the position that you by nature are so self-absorbed that you are a bad friend and only AA taught you how to be a good friend who listens ...

I didn't give AA the credit. Your assumption that I did becomes the basis for a fairly elaborate anti-AA point. Such errors lead me to seriously question the perceptions of the anti-AA crowd. AA didn't teach how me to be a good friend (though it helped me become a more useful and responsible friend). AA helped me recognize my weaknesses and optimize my strengths.

Originally Posted by causeandeffect

... this is what I mean about being in a negative relationship with your self.

If I have a negative relationship with myself, it's not AA's fault. Your line of reasoning here is based on an erroneous premise.

Originally Posted by causeandeffect

And it seemed to always be the nice people who soaked up these negative messages ...

What the hell makes you think I'm nice ?

You've spun this whole scenario that includes the phrase "these negative messages" based on a claim I didn't make. Some people do give AA the credit for turning them into a better human beings. In some cases it's probably true.

Originally Posted by causeandeffect

Do you mind expanding on how AA integrates mind and body? And the autonomic nervous system?

I never attributed it to AA. To see what I really wrote, scroll back about 20 posts. There is a drive for "healing" and "wholeness." AA supports this process. I don't want to start a sermon on the benefits of integrating mind and body. Maybe tomorrow.

Originally Posted by causeandeffect

Exactly. But I would argue that the act of voluntarily going to AA shows motivation in and of its self ...

Of course it shows motivation. But in one of those mind-body interactions it turns out that attendance can help build and sustain motivation. Nothing succeeds like success. Even hating it can provide motivation - as in, I'll show them, I'll get sober without AA!

[Hallo Alfie]

Originally Posted by Bamberger

That's a whole lotta God, I'd say. Also, percentage-wise how many meetings worldwide do you think either begin and/or end with the Lord's Prayer or Serenity Prayer? Let's say it's > 90%. Just a guess, but let's say it's about that. Does this mean that the individual members collectively agree to utilize such prayers? I would say yes, assuming that groups truly are autonomous.

This would then mean that the members are willingly using Christian prayers based on their personal beliefs in a Christian God. Christianity is a religion, albeit one with many sects and denominations. Is AA just another religious sect? Yes, I would say so.

Firstly, I have never attended a meeting that included the Lord's prayer.

Second, God (in the serenity prayer) is still a god of your understanding (or spiritual expression). How come people don't get this? It isn't difficult.

[causeandeffect]

Originally Posted by A.A. Alfie

You are talking motivation here, not treatment. I may be missing something but I'm honestly not sure what you are trying to show us.

I’m showing that motivation is what predicts success, not AA or treatment:


“Pretreatment AA affiliation was not found to influence prognosis significantly.”


That means that those who had been to AA before were in just as bad shape as those who hadn’t. It means they have no advantage over others who have not been to AA.


“However, an infrequent or irregular pattern of posttreatment AA attendance was associated with a much poorer prognosis than either regular attendance or nonattendance. Success:failure ratios were statistically equivalent for the latter two groups.”


"The latter two groups" means the last two groups mentioned which were regular attendance and nonattendance. The ratio of success to failure was exactly the same whether they went to AA all the time or never went to AA at all. I know how fond you are of repetition so:

Regular AA attendance resulted in the exact same success as never going to AA.

Again, regular AA attendance resulted in the exact same success as never going to AA.

And again, regular AA attendance resulted in the exact same success as never going to AA.

Going to AA occasionally just a little made the prognosis much worse. In other words, going to AA on a regular basis had no effect. Going to AA occasionally made things worse.



And for the second study, let me try to break this down so you can understand:


“comparing brief interventions with control conditions in non-treatment-seeking samples” proved “small to medium aggregate effect sizes in favor of brief interventions.”


In other word, brief interventions alone were successful even with severe cases.


“significantly larger when individuals with more severe alcohol problems were excluded”


The effects were good with severe individuals included, but much better when severe cases were removed.


“For studies of the second type,” which were “comparing brief interventions with extended treatment” it was found “the effect sizes were largely not significantly different from zero.”


That means that brief interventions are just as good as long term treatment.


Taken all together, what all of this means is that brief interventions work better than nothing at all, and are just as good as long term treatment, even on some of the most severe cases:


The results concur with previous reviews that found little difference between brief and extended treatment conditions.”


Now do you understand? If not, here’s what the peer review found.

“Effectiveness of brief interventions proved beyond reasonable doubt.”


http://www.ncbi.nlm.nih.gov/pubmed/11964102


So taken all together, obviously motivation is what predicts success. Some people who are highly motivated will seek help and go treatment and/or to AA but doing so is superfluous. Motivation doesn’t require 12 steps or long term treatment to work and can be enhanced with a brief intervention. The key is motivation and readiness for change.

[Bamberger]

Originally Posted by A.A. Alfie

Firstly, I have never attended a meeting that included the Lord's prayer.

Second, God (in the serenity prayer) is still a god of your understanding (or spiritual expression). How come people don't get this? It isn't difficult.

Your first statement means nothing, considering your second statement. I grouped both prayers together as being Christian. The latter was written by Reinhold Niebuhr, a protestant theologian. The Serenity Prayer makes a reference to Jesus (indirectly, but obviously) in a later stanza.

This is a type of bait and switch that is common in AA. Use the first stanza of a prayer and mention God. Inculcate the member with a concept of a higher power (God) through constant repetition of this prayer, then expose them to the other stanzas later on...hence conversion to/reaffirmation of Christianity, a by-product of constant exposure to doctrine at meetings.

[Minoosh]

Originally Posted by Bamberger

... This would then mean that the members are willingly using Christian prayers based on their personal beliefs in a Christian God. Christianity is a religion, albeit one with many sects and denominations. Is AA just another religious sect? Yes, I would say so.

Some interconnected experiences in and around AA led me to see it more as a liberal form of Islam. I never voted on use of prayers, but willingly join the Lord's Prayer, and it's not based on personal belief in a Christian God, any more than the Serenity Prayer is. I'm signing off on the language, not its point of origin. If the prayers reflected specifically Christian doctrine, I don't think I could say them.

[Hallo Alfie]

Originally Posted by causeandeffect

I’m showing that motivation is what predicts success, not AA or treatment:

Fair enough. And I am showing you that motivated people who attend AA in conjunction with other treatment options (i.e. Detox and rehab in whatever form they take) have twice the chance of recovery.

Originally Posted by causeandeffect

So taken all together, obviously motivation is what predicts success.

No. It is one predictor as to how motivated people are to achieve success. [/quote]

This goes to the heart of "rock bottom" a term I am pretty sure you will dislike. One must be at rock bottom to be sufficiently motivated. Clinicians and therapists understand this completely - there is no point sending anyone to any rehab, to AA to SMART or anywhere else and expect them to attain sobriety of they are not ready.

Your study provides a great deal of support for the stages of change model and my earlier explanations around rock bottom.

Thanks again.

Originally Posted by causeandeffect

Some people who are highly motivated will seek help and go treatment and/or to AA but doing so is superfluous.

Demonstrably untrue - please refer to the study you seem to not wish to discuss where it outlines that people who attend 12 step fellowships have twice as much chance of recovery than those who don't.

Originally Posted by causeandeffect

Motivation doesn't require 12 steps or long term treatment to work and can be enhanced with a brief intervention. The key is motivation and readiness for change.

Brief intervention works very well for people with less severe problems as outlined in your study.

A simple example would be a person who has experienced a trauma (say the death of a partner). This individual uses alcohol to help cope but doesn't return to normal use. A brief intervention through some bereavement counselling (and maybe a detox) will probably set this person right.
This would not happen with an alcoholic.

[Bamberger]

Originally Posted by Minoosh

Some interconnected experiences in and around AA led me to see it more as a liberal form of Islam.

Well, yes, if we view both religions from the prism of abstinence. I sincerely hope however that in the future we don't see fanatical members with gunpowder-filled Starbucks coffee containers strapped to their bodies blowing themselves and others to kingdom come.

Originally Posted by Minoosh

I never voted on use of prayers, but willingly join the Lord's Prayer, and it's not based on personal belief in a Christian God, any more than the Serenity Prayer is. I'm signing off on the language, not its point of origin. If the prayers reflected specifically Christian doctrine, I don't think I could say them.

Ok, I can buy that, tradition being what it is. I would venture to say however that the majority of people saying such prayers do associate with a Christian God. And I can in no way prove this.

[DannyB II]

Originally Posted by Bamberger

The heavy use of the word God in both AA literature and in prayers at meetings makes it religious.

This is a true statement.
I say it can be religious as one wants it to be, seriously. I am really testifying to my own experiences and ones I have witnessed with friends and friends of friends.
There are so many spiritual people today that are practicing their enlightenment in and out of AA. You don't have to be agnostic or atheist to disregard the references to god.
There is no way everyone here is going to tell me that they haven't noticed in their world today how many people have turned away from traditional religion (churches, Bible ect..).

[Minoosh]

Originally Posted by causeandeffect

The ratio of success to failure was exactly the same whether they went to AA all the time or never went to AA at all.

Would the people who liked attending AA regularly have stayed sober in equal proportions if they hadn't had the AA option?

The regular AA cohort tended to have had more severe consequences at the time of admission than the non-attenders. So, these are not the same population.

Originally Posted by causeandeffect

Some people who are highly motivated will seek help and go treatment and/or to AA but doing so is superfluous.

I don't agree that the study predicts the best outcome for an individual, for the reason above. Motivation is a dodgy critter.

Originally Posted by causeandeffect

Motivation ... can be enhanced with a brief intervention.

Does getting arrested count?

[Minoosh]

Originally Posted by Bamberger

This is a type of bait and switch that is common in AA ... expose them to the other stanzas later on...hence conversion to/reaffirmation of Christianity, a by-product of constant exposure to doctrine at meetings.

I never heard anyone even allude to more stanzas.

Originally Posted by Bamberger

Well, yes, if we view both religions from the prism of abstinence.

I wasn't even thinking of the abstinence part. It's more a philosophical outlook for me. Also - I don't particularly associate Christianity with abstinence. Certain denominations perhpas.

Originally Posted by Bamberger

I sincerely hope however that in the future we don't see fanatical members with gunpowder-filled Starbucks coffee containers strapped to their bodies blowing themselves and others to kingdom come.

Your best bet, dive for cover if someone screams, "Allahu akbar!"

Muslims invented coffee, do you know that?

Originally Posted by Bamberger

I would venture to say however that the majority of people saying such prayers do associate with a Christian God.

Maybe it's a regional thing but whenever anyone brought up their "higher power" it was hardly ever the traditional Christan God.

[qayak]

Originally Posted by A.A. Alfie

Demonstrably untrue - please refer to the study you seem to not wish to discuss where it outlines that people who attend 12 step fellowships have twice as much chance of recovery than those who don't

“However, an infrequent or irregular pattern of posttreatment AA attendance was associated with a much poorer prognosis than either regular attendance or nonattendance. Success:failure ratios were statistically equivalent for the latter two groups.”

What part of "statistically equivalent for the latter two [regular attendance and non-attendance] groups" do you not understand?

[Bamberger]

Originally Posted by qayak

“However, an infrequent or irregular pattern of posttreatment AA attendance was associated with a much poorer prognosis than either regular attendance or nonattendance. Success:failure ratios were statistically equivalent for the latter two groups.”

What part of "statistically equivalent for the latter two [regular attendance and non-attendance] groups" do you not understand?

pretty easy to grasp, but hey, faith and logic don't always mix well.

[Multivac]

Originally Posted by A.A. Alfie

"When, therefore, we speak to you of God, we mean your own conception of God. This applies, too, to other spiritual expressions which you find in this book.".

But why do you need to involve spiritual expressions at all? What if you don't have a spiritual side? Also, as an atheist, I have no ceonception of god because he/she/they/it doesn't exist.

[Minoosh]

Originally Posted by qayak

What part of "statistically equivalent for the latter two [regular attendance and non-attendance] groups" do you not understand?

I believe Alfie and C&E are citing different studies.

[Minoosh]

Originally Posted by Bamberger

This would then mean that the members are willingly using Christian prayers based on their personal beliefs.

Sometimes if I wake in the middle of the night I chant in my head to fall back asleep. I just noticed something about the Lord's Prayer and the Serenity Prayer. Only occasionally am I even focusing on the words. It's the cadences. If someone played them on a kazoo I think I'd recognize them. For those of us with no abhorrence for prayer - the opening word/phrase, pause, deep breath and four-count beat, even holding hands (if they haven't been sneezing all meeting, although that, paradoxically, can be countered with hand sanitizer which is ... ethanol) - lead to a slightly altered state. This relaxation respone doesn't last long, but it's reinforced over time. That could be one of those autonomic nervous system responses I alluded to earlier. Which somehow brings me back to music as a higher power.

Certain language doesn't work for me - I'm too aware of doctrinal humps, which might not bother me if I didn't know the meaning of the words.

"May peace be with you ...and also with you" is a bit of liturgy I buy into, other bits I might not use.

[Hallo Alfie]

Originally Posted by Multivac

But why do you need to involve spiritual expressions at all? What if you don't have a spiritual side? Also, as an atheist, I have no ceonception of god because he/she/they/it doesn't exist.

Everyone has a spiritual side. It includes the reasons we get out of bed, love our families, self esteem, work, goals and goal setting, projects. It is our purpose, our duties or obligations. It can be service to others, self improvement and education. It can also be religion, philosophy or or a way of life. Add your own forms here *.............*

Spiritual expression means so much more than the narrow definitions that some here would have us believe and limit us to.

Originally Posted by Minoosh

I believe Alfie and C&E are citing different studies.

Exactly.
C&Es is about motivation which goes to the heart of "rock bottom".
The other is about AA as a form of maintenance and ones' double or better chances of success when use in conjunction with other treatments.

Completely different. The former a sad effort to negate the latter.

I will be happy to explain further for those that find the concept hard to understand.

[Minoosh]

Originally Posted by A.A. Alfie

If you want to use a bedpan, a doorknob or a spaghetti monster, knock yourself out.

There are times when I worship toilets. I call it transcendental urination.

[Bamberger]

Originally Posted by A.A. Alfie

Everyone has a spiritual side. It includes the reasons we get out of bed, love our families, self esteem, work, goals and goal setting, projects. It is our purpose, our duties or obligations. It can be service to others, self improvement and education. It can also be religion, philosophy or or a way of life. Add your own forms here *.............*

Spiritual expression means so much more than the narrow definitions that some here would have us believe and limit us to.

Some of us like to think of all this as instinct, honed through generations of evolution. Better yet, many of us don't dwell on it much at all. We just live our lives free of superstition and spend our finite time here on earth preparing the next generation for their tasks at hand.

[causeandeffect]

Originally Posted by A.A. Alfie

C&Es is about motivation which goes to the heart of "rock bottom".

Yes, AA advocates a necessity for people hitting “rock bottom” before any changes in drinking can be made. Fortunately, as we can see by the study I provided
it is not necessary to wait for this truly devastating state to occur. While it is possible to motivate change in those at the more serious end of the spectrum, it is significantly more difficult. Waiting for someone to hit bottom reinforces the neural pathways for addiction making it harder to change, not to mention having nothing else to lose makes it harder to motivate. The notion of “hitting bottom” being something one has to reach in order to conquer addiction takes a huge toll on the individual, their loved ones, and society in general. It’s just another area where AA is wrong. Deadly wrong.

Techniques such as brief interventions and motivational interviewing have been shown repeatedly to have really significant effects. Here’s another article:

http://onlinelibrary.wiley.com/doi/1...820.x/abstract

"To date, the literature includes at least a dozen randomized trials of brief referral or retention procedures, and 32 controlled studies of brief interventions targeting drinking behavior, enrolling over 6000 problem drinkers in both health care and treatment settings across 14 nations. These studies indicate that brief interventions are more effective than no counseling, and often as effective as more extensive treatment."