According to a 2004 report from the National Institutes of Health, an estimated 17.6 million American adults (8.5 percent) meet standard diagnostic criteria for an alcohol use disorder. The most widely known option in the world for people who want to quit drinking is Alcoholics Anonymous (AA), with an estimated membership of over 2,000,000 people in 180 countries. However, is AA the best and only option for recovery from an alcohol problem? In this four-part article, I will provide a critique of AA’s 12-Step model, and provide alternatives to AA that are not as widely known, but have been very effective in helping many people recover from an alcohol problem.
Part One: Steps 1-3
Step One: We admitted we were powerless over alcohol—that our lives had become unmanageable.
If one is powerless over alcohol, how can one ever stop drinking? If AA means by this that a person needs to accept that alcohol is destroying his life, this makes perfect sense. But accepting that one has a problem and saying that one is powerless against that problem are two different things. In fact, those who attend AA are not powerless. They take many actions within their own power, such as attending the meetings, reading the AA literature, and eventually, refraining from drinking. As a clinician, both theoretically and clinically, I would never hold the view that a client is powerless. Even quadriplegics can accomplish many things through their own free will, even though they are paralyzed from the neck down. To communicate to a client that he or she is powerless, whether it’s to depression, anxiety, or drinking, is to communicate to them that they have no control over their lives and that they are fated to their current condition. Not only is this untrue, it would be extremely damaging to a client’s self-esteem and his ability to help himself get better. The fact is, countless people have quit drinking using AA and other approaches (including quitting on their own), which means they did exert power over their problem.
Step Two: Came to believe that a Power greater than ourselves could restore us to sanity.
AA says that you must give yourself up to a Higher Power in order to overcome your drinking problem. However, the concept “Higher Power” is not clearly defined. AA says that a Higher Power does not necessarily refer to God or religion, but it is described as a “Power greater than ourselves,” which means in essence, something non-human. This sounds like hair splitting to me, and I wonder why AA does not just say that Higher Power refers to a mystical force based on faith, instead of trying to distance itself from God and religion. Whichever way AA defines Higher Power, the idea requires one to give up his own personal power to a “power” outside himself that will stop him from drinking. How is this actually accomplished? This is not stated clearly in the AA philosophy.
Step Three: Made a decision to turn our will and our lives over to the care of God as we understood Him.
In this step, the word “God” is used explicitly, even though in the previous step, God is referred to as a “Power greater than ourselves.” Again, no matter what word you use, Higher Power refers to a mystical force that one must follow by faith. But, is this the best message to give to someone who supposedly has no control over his life? He has no power to stop drinking on his own, so he must put that control into the hands of some vaguely defined spiritual force? But, no one knows what this ‘force” is, because one must determine it for himself as he understands it. Since no one that I’m aware of communicates directly with God, whom will the AA member give up his power to? He must give it up to his peers in the AA group, since there is no defined leader of the groups. But is this the best message to give to someone who believes that he has no control over his drinking problem? You are, in essence, communicating to that person that, since he has no control over his own life, he must put the control of his life into the hands of others who represent the “Higher Power.” This would seem to do nothing to help a person gain the skills and the confidence necessary to take control of his own life and also take credit for the success of quitting or the failure of not quitting alcohol.
(Originally appeared on Examiner.com)