Posted by JLx on October 12, 2004, at 20:57:47
In reply to Re: 12 step programs, posted by mi nación malvada on October 12, 2004, at 0:52:19
> Cass, thanks for your kind words on that other page. I am familiar with 12 steps programs and have reviewed meta-analysis of most of the research that measured the efficacy of those programs in comparison to other approaches for behavioral modification among people damaged by alcohol consuumption. The meta-analsis suggests they are not very effective - certainly not as effective as more direct interventions by trained professionals.
The last I heard (and I admit it's been a few years since I was an active 12-stepper) the treatment centers were using some variation of the 12-steps if not actual AA meetings themselves. AA was formed because doctors and psychiatrists of the day were spectacularly unsuccessful in treating alcoholism.
What are the other behaviorial modification approaches and direct interventions that are now successful?
I also note that I think it's extremely hard to measure the efficacy of a self-help, voluntary spiritual program where the goal is not simply to quit drinking. Central to the self-help paradigm is that one must be ready. And how does one measure that a seed was planted? It's fairly common for people to cycle through rehab or AA several times before it "takes", for instance.
AA is not going to be everyone's cup of tea, but I would encourage anyone with a serious addiction or related problem to put it to the experiential test.
> That does not mean they are not effective for some people. In a book about treatment of alcoholism from Johns Hopkins University, an author concluded, rather frankly, that the programs work as a sort of "surrogate addiction."
I would agree with that, but also note that a more healthy surrogate addiction may be just the transition that some people absolutely need.
> The role of faith in 12 steps groups is not addressed in the Johns Hopkins text.
Then I would question their understanding. Anyone in "the program" would tell you it's a spiritual program. Faith is integral.
> I would suggest the groups work primarily by providing social support, which, if we are extremely honest, is nothing different from crowd dynamics and peer pressure. It's simply a matter of choosing which peers one will allow to apply pressure.The social support is a major factor, I agree, but I think peer pressure is something of a misnomer. While there is some pressure to adhere to the tenants of the program itself (or else why be there?) most people experience a freedom from the kind of pressure they've been burdened with from the problem that's brought them there and how it has affected their lives. It's more than just a passing comfort to be with people who REALLY KNOW your own kind of pain.
>The 12 step programs don't require that we identify this higher power as anything more than our own inner voice - what is important for the operation of the group is collective surrender. Whatever is this "higher power" we embrace, it serves to legitimize the authority of the group, whose primary authority in turn is in the area of pressuring us to behave in a certain way.
The idea of surrendering to a higher power is to get beyond one's ego. Everything is perception, but in general, I would say that it's probably not listening to one's own inner voice so much as attempting to listen for something other than our voice.
"Be still and know that I am God" Psalms 46:10
Look within.
Be still.
Free from fear and attachment,
Know the sweet joy of living in the way.
--BuddhaWhen the five senses and the mind are still, and reason itself rests in silence, then begins the Path supreme. –Katha Upanishad
"Reason itself rests in silence". I like that.
I think what many people who study AA from outside fail to appreciate is that it IS a spiritual program. The language of the 12-steps is clumsy and the binding ingredient of addiction (or whatever the purpose of the group) complicates the picture, but at its heart it's teaching a method to transcend the ego-self, to achieve faith.
The first three steps are often shortened to:
First we came,
Then we came to,
Then we came to believe.>My faith holds that my life matters nothing at all and that life itself has no inherent meaning whatsoever.
Do you mean this as an acknowledgement of perceived fact, or is this your chosen philosophy?
JL
poster:JLx
thread:395948
URL: http://www.dr-bob.org/babble/faith/20040914/msgs/402417.html