There are a lot of lonely people out there. There are a lot of people who never get to talk about what is really going on with them. Addiction groups are an awful lot like support groups, except they are focused on a common experience. They give people a chance to talk; to confess; to make friends; to share their shames—all without being shamed. Folks hang out with each other and they can finally talk about all the shit on their minds. That’s a rare thing.
Addiction groups are also a lot like religions. They have their saints, their bibles and their rituals. These things all help strengthen the cohesiveness of the group and they also allow folks to travel from group to group and have something familiar wherever they go.
I’m not big on ritual, especially their rituals, but I don’t mind that much. It’s really boring to have the rules read every beginning of the meeting I go to, but there is a regular schedule of topics to discuss and it is interesting hearing other people’s stories. The folks sometimes hang out after—just talking or maybe getting some food. They have social activities as well—some just for us, and some for us and our families.
As to cure rates—well, I knew they weren’t as high as advertised before I went in. My wife and my therapist wanted me to go, so I could make all happy and get to tell stories and make friends at the same time. So that’s why I went. Of course, my addiction isn’t a substance but a behavior, so things are probably different here. I also go to another support group that is also about behavior. Although, come to think of it, abusing a substance is a behavior, too. In one of my groups, most people have the opposite problem—they don’t take their drugs when they should.
Do these things help? It all depends on how you define the problem and the criteria for the solution. What is alcoholism? What does it mean that many alcoholics drink in moderation? What does it mean when someone is better?
I don’t know if there is a medical definition of alcoholism. Functionally, though, I think most people consider it an addiction when the behavior is destructive of their lives. They are improved when they are able to build their lives back up. Both of these things are very subjective, and can only be measured with a survey, if they can be measured at all. I don’t think people would go if they didn’t think they got some benefit from it. Do their behaviors change as a result? I don’t know.
How can we establish a standard for positive behavior change? How can we know whether the change would have occurred with or without the participation in meetings? There are just too many subjective factors in this for me to believe that any research about it provides useful information.
I don’t think AA or any other addiction program is self-delusional. I don’t know if people know what they are getting into, but I think they feel whether it is right for them or not, and choose to participate or not based on that. If it feels right, then that is one standard of success. And your tautology is correct, the meetings are made up only of people that it feels right to.
There are, of course, people for whom it feels wrong, and they don’t go after the first or sixth meeting or whatever. Now, if you are measuring the success of a treatment, does it make sense to include people who don’t get the treatment in your study? You’re getting a selection bias there, which will throw off your results.
I think there are two main problems with AA groups. They may not do what they say they are doing, and they have an overt religious component. Personally, I find the religious imagery and language somewhat annoying, but I find that if I ignore the language and focus on the experiences people describe, then I can relate to those experiences, and I have experienced similar things.
When people talk about giving up to their higher power, I get a sense that they are talking about a complete and utter giving up. I know that feeling. I employed it, without knowing anyone else does it, to help recover from depression. When I gave up fighting my depression, it lost some of its power, and I was able to turn myself around. I don’t know if that’s what addiction people are talking about, but it’s good enough for me.