IS TWELVE-STEP MENTALITY HOLDING US BACK? A Rational Man’s Resistance

IS TWELVE-STEP MENTALITY HOLDING US BACK?
A Rational Man’s Resistance


By Michael Dorian
Twelve Step treatment has been embraced in this country with virtually no
resistance since its inception in 1939. Millions of Americans enroll each year in various
12-Step programs which are all founded on the God-based approach of Alcoholics
Anonymous.

There is also, and has been for some time, an alarming trend within our medical
community toward believing that 12-Step treatment is the single way for people with
substance abuse problems to recover.

A large recent survey of this country’s substance-abuse treatment providers
showed that 93% of the 450 facilities included utilized the 12-Step model. When
considering only inpatient facilities, this number is even higher, at 96%. In the New York
area, all of the major hospitals or treatment centers for substance abuse utilize the 12-Step
methodology.

I am an atheist. In 2000 I felt compelled to seek help for an intravenous cocaine
problem. So I searched all over the greater New York area for a substance abuse program
that did not use the 12-Step method. But there simply weren’t any. In the rehab where I
was eventually treated, New York Presbyterian Hospital-Cornell Medical Center in
White Plains, NY, every day was begun with a prayer. AA’s stand-by “Serenity Prayer”
was used to close many group sessions, and there was an evening prayer to end each day.

(It may be worth noting here that several U.S. Circuit Courts, including New
York, have found AA and 12-Step treatment to be “pervasively religious” in nature and
these courts have ruled that mandating people into this type of treatment is a
constitutional violation of the First Amendment’s Establishment of Religion Clause.)

So with no other feasible treatment option, I “voluntarily” entered this 21-day, 12-
Step inpatient facility. A reference to God, or something very much like God, appears in
six of the Twelve Steps. Step Three states that one turn his will and his life over to the
care of God. I repeatedly insisted to doctors and substance abuse counselors that it would
eventually be my own will which would help save me from the sure and utter ruin of
excessive cocaine use. I was invariably told by these same doctors and counselors that I
had virtually no chance of recovery unless I had faith, faith in something other than
myself. As I soon learned, having faith in one’s self, and no faith in a higher power, is
anathema to the 12-Step worldview.

In rehab it was continually suggested to me that once I had completed my
inpatient stay, I should continue with after-care at this same facility’s 12-Step-based
outpatient program. Without knowing that this was to become an integral part of my
dilemma, I was also told that I would have to remain “in compliance with treatment” in
order to ensure the continuation of my state-supported benefits.

So after completing the 21-day inpatient stint, I agreed to enter the outpatient
program. And the need for me to turn my will and my life over to God was reiterated by
all my new doctors and counselors. If I didn’t, they told me I stood little or no chance of
recovery. An intensive effort was made on all fronts to persuade me to swallow their
philosophy. I continued to participate, in body and not mind, because I’d looked around
for programs which weren’t based on the 12-Steps and there just weren’t any. Moreover,
had I left the program, my benefits from the state of New York would have been
discontinued once I was no longer “in compliance with treatment.” This was made all too
clear to me by every case worker, counselor, and doctor I encountered. However, being
unemployed and ravaged by my habit, I needed the benefits. So I stuck it out.

After a year of rehab, I was discharged. It’s not that I’d finally ingested their
attempts at indoctrination. Au contraire, I haven’t been near an AA or NA meeting since,
and nor have I used cocaine. I wish it were a simple thing to nutshell, what it takes to get
control over an addiction. Wrestling with it was the most difficult thing I’ve ever faced.
Hopefully that I will ever face. For me, regaining an interest in my interests was both
pivotal and crucial.

But what are the options aside from 12-Step therapy? Other forms of treatment do
indeed exist which are acknowledged by health care professionals and psychotherapists.
The most prominent type of alternative treatment for those with alcohol or substance
problems is something known as Rational Recovery, or its sister treatment, SMART:
Self-Management And Recovery Training. It is a total abstinence approach to addiction
without the requisite faith in a higher power and without the literal dogma.

But trying to find a facility which offers this as an option is practically
impossible, especially if the bill for treatment is to be footed by a state-funded
Department of Social Services. Everyone I encountered in this system whom I asked
about Rational Recovery seemed unable to even fathom it as a possibility, much less
point me to a place that used this form of treatment.

Is it the nature of our societal beast to have matters such?

Aside from the difficulty avoiding AA-based models of treatment in cases where
someone prefers an alternative (non-religious) form of help, as is broadly safeguarded in
our Constitution, there might be little problem accepting the snafu that there aren’t easily-
found practical alternatives. Except for one thing: statistical research clearly indicates that
12-Step treatment is often less effective than other very-hard-to-find forms of treatment.
Perhaps the primary reason the 12-Step approach, based on AA’s principles, has any
success rate is that it’s virtually the only game in town.

As for scientifically valid studies on the efficacy of AA, there haven’t been many.
Two, to be precise. The first is The Ditman Study, conducted in San Diego in 1964 and
1965. The second, done in 1980, is The Brandsma Study. Simply put, both studies led to
unimpressive conclusions about AA’s merit as substance-abuse therapy. Suffice it to say
that studies of 12-Step treatment itself have shown similarly poor results concerning its
efficacy in comparison with other methods.

Why then the dogged clinging to this not scientifically-proven, relatively
ineffective means of treating substance abuse in this country? Certainly if the medical
and healthcare communities widely sanctioned other approaches, the health insurance
industry would follow suit and provide coverage in appropriate cases. So if it’s the
medical community who is so in league with the 12-Step/AA approach, where does this
non-scientific methodology come from? Psychiatrists and other clinicians shouldn’t
really be in the habit of relying on faith in God to cure the “diseased,” so why then is this
country’s most widely-used treatment method a faith-based one? Sure, they prescribe
whatever medication is at their disposal to help people with their substance problems, but
they also generally embrace the whole 12-Step approach, and the medical mainstream has
certainly offered no significant resistance to this methodology.

Perhaps it is the stalwart religious nature of America’s population that’s gotten us
here. Ninety-five per cent of the people in this country say that they believe in God. But
what about the non-believers among this country’s population? Where’s their fair shake
at drug and alcohol rehabilitation? To be sure, they make up a very small minority of the
populous, but if we are to use that line of reasoning as an excuse to overlook this
problem, why did people care about giving African-Americans—who made up only
about 10% of this country at the time—their civil rights? It is not the size of the group
that matters, but rather the protection of our personal liberties from being overrun
because they are simply not that popular.

And there may be an even greater price to pay for overlooking this lack of non-
religious treatment for substance abusers, and this may be the gravest of all the societal
implications: the failure to progress in our thinking as a nation. Copernicus tried to show
that the Earth was not the center of our solar system, and contrary to popular belief, he
was right. For a similar idea, Galileo was excommunicated. Up until Columbus’ era, a lot
of people thought the world was flat. Newtonian Mechanics has been repudiated by our
advanced knowledge of Quantum Mechanics. And another recent and equally startling
example is that the originator of the lobotomy was granted the Nobel Prize for medicine
in 1949. The gentlemen who came up with AA’s 12-Steps preceded him by only ten
years. Something which has been a commonly held belief for a time obviously does not
give it ultimate validity, and it certainly does not endow it with an immunity from being
questioned and challenged.




Michael Dorian’s first book, “The Nektonic Facteur: Poems & A Play”, was published in 1998.
His work has been in The International Fringe Festival three times. He would like to
sell one of the numerous screenplays he’s written soon. He just signed on to do vocals for
a really good band in NYC with a really bad name: McCallister. He also smokes and does
Bikram yoga. But not simultaneously.