Prayer doesn’t work. Miracles don’t happen. Faith and spirituality are nothing but magic words for nothing at all. So what is a church to do?
Easy. Buy something that does work, and slap a religious label on it. So the Catholic hospitals are busy growing again.
Catholic health care services are buying up an increasing number of hospitals in the United States — 1 in 6 hospitals now answer to the Catholic authorities — and in many towns, the only hospital in the area is Catholic. This normally wouldn’t be a problem, except that these hospitals usually have to follow the Ethical and Religious Directives for Catholic Health Care Services, which expressly forbid any care seen as fiddling with the “natural” course of reproduction. Interpreted faithfully, means no abortion, no contraception, no sterilization, and a ban on many fertility treatments.
It’s win:win for ignorance! Not only does Catholicism get to claim credit for scientific successes, but they get to spread harmful doctrines at the same time!
Here’s another case of a ‘higher power’ inflating it’s potency: 12 step programs. They don’t work.
There is a large body of evidence now looking at AA success rate, and the success rate of AA is between 5 and 10 percent. Most people don’t seem to know that because it’s not widely publicized. … There are some studies that have claimed to show scientifically that AA is useful. These studies are riddled with scientific errors and they say no more than what we knew to begin with, which is that AA has probably the worst success rate in all of medicine.
It’s not only that AA has a 5 to 10 percent success rate; if it was successful and was neutral the rest of the time, we’d say OK. But it’s harmful to the 90 percent who don’t do well. And it’s harmful for several important reasons. One of them is that everyone believes that AA is the right treatment. AA is never wrong, according to AA. If you fail in AA, it’s you that’s failed.
It’s always the victim’s fault when it comes to faith-based treatments. The very first comment there is a perfect example of religious apologetics.
I’m a recovering addict/alcoholic with over 5 years of continuous sobriety. I attend AA meetings regularly, and I take exception to Dr. Dodes statement, “AA is never wrong, according to AA. If you fail in AA, it’s you that’s failed.” I have never attended a meeting where this sentiment was expressed. The AA Big Book says, “Rarely have we seen a person fail who has thoroughly followed our path.”
Exactly. It doesn’t work, the stats show it doesn’t work, but according to AA, it always works, except when it’s the subject’s fault, which is 95% of the time.
Even the claim of 5% success is bullshit. There’s no control group. Who knows if those 5% wouldn’t have succeeded without it? Who knows if the success rate without AA would have been 20%? In fact many people just quit on their own.
My elderly father was hospitalized with pneumonia. He had moderate dementia too but it was always much worse when he was sick. The nurses at the Catholic hospital tried to talk me into letting him die. The next day he was sitting upright and smiling at all the nurses. He lived for four more years. I could understand if they had asked me about his course of treatment and discussing his options but they just gave unwanted advice.
It’s all about the tax-sheltered income. Churches and hospitals are super profitable and need to invest in stuff so they can continue to “break even” after operating costs. It’s a scam. Unfortunately religious scammers owning hospitals is going to work out to more medical scams.
Just some randomish thoughts about the AA thing.
I don’t personally buy the argument that the majority who fail while in AA are measurably ‘harmed’ by the disappointment of not living up to the expectations of the program. If there is harm there, it is surely nothing compared to the harm that is happening by their addiction which is steadily destroying them.
For fun, though, lets suppose that the 5-10% success rate is true for AA since that is the claim and it was not disputed. If you had a disease that will gradually devastate your family and eventually kill you, but there was a treatment with a 5-10% chance of success, would you take it? What would be the alternative?
Finally, how do we know it is even 5-10% (maybe AA does not work at all!) Could it be that a small fraction of alcoholics recover on their own?
Next thing your gonna tell me is that flossing does not work :/
Re: Marcoli (#4):
I, on the other hand, can imagine very well that someone, who is at a low point in their life, is being very much harmed when the standard (or only) treatment plan is also telling them that it’s their fault for failing. That’s just the kind of encouragment people need in that situation.
“Gee, thanks, I guess I’ll just try the exact same thing again.”
Funnily enough the bolded statement can be applied as is to the religious.
“We have never seen a Believer go to hell who thoroughly followed our path.”
Unfortunately nobody is quite sure what that path is and, judging by the prominent guide books, it has more than a few forks in it, where the faithful had better split themselves in two and follow both at once, but hey. As for harm: catholicism is absolutely depressing.
First of all, I didn’t realize what AA stood for at first so I was going through the possibilities in my head and knowing the Catholic Church I just sort of assumed it stood for Abstinence Only, not realizing Only starts with an O.
Anyway, if a 12-step program doesn’t work, clearly a 14-step program is needed! (Not 13 because that’d be unlucky CLEARLY) Steps 13 and 14 are “do better” and “GOD (which stands for Gigantic Ousting of the Devil)”. Bonus step 15: hug a priest
I’d be curious to know what addiction treatment works.
“Rarely have we seen a person fail who has thoroughly followed our path.”
Rarely have we seen antibiotics fail for a person who has thoroughly followed the regimen. I almost always works except when it’s the patient’s fault.
in all this talk about AA and 12 step programs from people who do not know very much about them there is one thing that is often over looked. There is no authority or hierarchy involved, there is no faith test or swearing allegiance or faithfulness to the program of the 12 steps nor to any god what ever.
one of the most unusual thing you will hear at meeting is this simple statement
“take what you liked and leave the rest”
the confusion comes I think from it’s very nature of individuals helping each other. Because it is made up of individuals none trained individual with similar experiences helping each other, some individuals and some groups may push for their own pet ideas of their own experience being the one true way. there is another saying you might hear from time to time that covers that
“some are sicker than others”
at some time probably in the near future there is going to be a big open conflict between religious health care rules and public payed for health care rights that is probably going to be a nasty fight
uncle frogy
Clearly, they’ve never seen anyone fail who has thoroughly followed our path”. Because they don’t look, they only carefully watch the people who stumble, not those who just breeze along the path.
Only those who succeed “followed the path”. Those who got lost, chose their own path. tsk tsk tsk.
ack
I
hatedislike giving God the credit for random stuff. Personally, surviving a terrible accident, all credit was given to Gawd, none to the people who rescued me, or my doctors, nor myself. People nod, saying “good thing I prayed for you”. yukSigh, not this shit again. Another graduate from the Dunning Kruger Institute of Addiction Studies publishes a book!
THERE ARE NO CREDIBLE STATISTICS OF THE SUCCESS RATE because there is no way to measure it:
1. There is no meaningful, objective measure of “success” in recovery. Anyone who says there is, is lying.
2. There is no meaningful, objective measure of the number of people in recovery. Anyone who says there is, has no clue about, um, counting.
3. There is no meaningful, objective measure of the number of people who are “successful” in recovery. See #1
FTFA:
This isn’t even close to being correct. From AA’s own words:
That all being said, any 12-step recovery will likely not work when it is forced upon the person. They have to want to do the program for themselves, not for anyone else. Thus, court-mandated attendance is a stupid waste of everyone’s time.
re @10, addendum:
“good thing I prayed for you”, expecting me to thank them for doing nuthin. double yuk
Oh, this ought to be interesting. AA’s more rabid defenders rank right up (down?) there with the worst creationists, religious apologists, MRAs, and pseudoscientists when it comes to bad faith argument. Some of the usual tactics include:
— the one-two punch of argument by anecdote and appeal to emotion: “AA saved my/my spouse’s/my child’s/my Uncle Larry’s life! If it weren’t for AA, I/he/she/em would be dead, in prison, or institutionalized. DO YOU WANT ME/HIM/HER/XE TO BE DEAD? DO YOU? SHOULD I JUST GO BUY A BOTTLE NOW?”
— loads of ad hominin: anyone arguing against AA’s effectiveness is accused of either having a grudge against AA, or being a ‘dry drunk’ (which usually means “person who doesn’t drink but is still an asshole,” though I’ve seen some AA’ers use it to refer to anyone who has dared to get sober through non-AA methods. (Might as well get this out of the way: I have no personal ax to grind here. I’m neither a current nor former drunk, have no close friends or family who used the program. I’m just fascinated and a little irritated by the way a religious self-help program has managed to get itself held up as the only option despite a lack of scientific evidence. I have no dispute with anyone who says they want to stick with AA because it seems to be working for them.)
— a little something I call the “12-step two-step.” They insist that “AA” works. But they can’t define what AA actually is, and when you criticize any supposed element of it (the 12 Steps, the Big Book, a higher power), it turns out that whatever you’re pointing to isn’t “really” part of AA, or at least isn’t required. Every AA meeting you’ve been to goes on and on about Jesus? Oh, that’s just those particular meetings. Turns out, your higher power can be a doorknob or a rock! Oh, it doesn’t make sense to turn your life over to a doorknob? Well, the steps aren’t strict commands. AA is just, you know, whatever your local group decides it is. But AA works! Uh, except for those who do it wrong. What constitutes “doing it wrong,” if nothing is mandatory and the program is all mush subject to group-by-group variance? Uh…. (crickets)
re 11:
[not to argue]
could they be using “success” instead of the more accurate, “remission”?
Meaning: the member’s recognition of ones alcoholism and commitment to remaining sober.
Success being quantified daily (ie, … been sober for X days.).
Given that, there is no such thing as success, only “successful so far”.
[seriously. I hope that didn’t come off as snarky.]
@7
Best treatment so far for addiction? Wanting to overcome an addiction personally + supportive community + therapy + anti-depressants and/or opioid antagonists. Of course, that’s hard to do, has to be pretty highly individualized, and not really practical for a lot people, but that’s the best science we have on it.
AA reminds me of the diet industry, and has about the same “success” rate.
shit I did it again post instead of preview
to comment on those quotes from 13
some AA’ers are individuals and have their own opinions and experiences
and you admitted do not have any experience with 12 step programs
you asked some in AA if they could define it and they could not but you could and did defined it as a religious self help program
sure you “might” hear jesus at some meeting but how would you know? you said you have no experience with 12 step programs?
have you even read what the 12 steps say?
it is a short read and nothing really new it wont capture your soul or anything.
uncle frogy
Just a quick suggestion: PZ linked to an NPR discussion of the Dodes’ book The Sober Truth. If people are interested in what’s behind their arguments, they might want to read it. (It’s not as good as, say, Johann Hari’s Chasing the Scream and I disagree with some of its arguments, but it seems kind of pointless to argue about it without engaging with their work or with previous criticisms or replies.)
unclefrogy,
I’m not sure why this comes as news to you, but it is possible to learn about what happens at AA meetings without attending one. Even if you don’t have close personal friends who attend them. You see, we have these communications devices that allow us to talk to all sorts of people around the world… perhaps you’re familiar with them. I’ve read extensive online arguments between AA defenders and AA detractors with actual personal experience. (Yes, of course, they could all be lying, but even many AA defenders in those discussions have admitted that yeah, that shit goes on in some meetings — they either like it, or put up with it, or find a different meeting.)
And yes, I’ve read the 12 steps. I’ve also read the tortured arguments of AA defenders who insist that they’re totally not religious. I’ve heard the arguments about doorknobs and rocks and Good Orderly Direction. And I’ve read the court decisions in the U.S. that uniformly smack down that nonsense and hold that it’s a violation of the First Amendment to order or coerce people into attending AA because of the religious elements.
Care to try an actual substantive argument?
(slightly off topic, but it’s related to catholic hospitals and I wouldn’t mind getting this off my chest)
I was born in a catholic hospital. It was a very difficult pregnancy for my mom. I was born premature and stuck in a incubator for my first few months of life. It was apparently SOP that when a premature baby is born to send a priest to baptize them asap.
My mom & dad were in a hospital the night I was born, not leaving my side. (inside a huge circa 1980’s incubator) When the priest entered the room and told my parents that I needed to be baptized right away in case I died in the night. My mom started sobbing uncontrollably. My dad tried his best to comfort her. And the priest opened up the incubator, splashed me with holy water, said a few magic words then left.
Obviously I don’t remember any of this, but it’s been told to me enough times as a family anecdote that I know how much it upset my parents. I think about it and get pissed off whenever I think about religion-run hospitals.
SC,
Further to your point, Here’s an interesting article from The Atlantic discussing the history of addiction treatment and some alternatives.
Anyone have a link to those studies giving the 5-10% success rate for AA?
I was raised in the Catholic church. I’ve been an atheist since the age of 14, nearly 50 years. The two often go together like that, no?
I’m also an alcoholic who, thanks to AA, has been sober for the last 24 years. Make of that what you will.
“The only requirement for membership is a desire to stop drinking.”
In Orlando, all the hospitals are owned by the Jehovah Witnesses. Thankfully. with the exception that they don’t serve any pork, they don’t follow any of their religious quackery. I personally have gotten transfusions at one of their hospitals.
By definition, if a person fails they have not thoroughly followed their path. It’s a little like saying if you don’t drink you’ll stay sober.
rorschach @22: There’s a criticism of the 5-8% figure here, with some references.
Ugh, I just ran into a morbid and relevant news story on tumblr:
Woman Dies after Prophet Puts Heavy Speaker on Her Body to Demonstrate a Miracle
Is he willing to have the same speaker put on himself? Or maybe a bit heavier because of course *his* faith would be stronger. @27
I should probably not say any more on this subject here but just this.
The most important thing to learn about that subject in the 12 step program goes like this.
“The only thing you have to understand about god is you ain’t it”
uncle frogy
@27:
Reminds me of some of the victims of the Salem witch trials, who were put to death by pressing. If only they’d had more faith…
marcoli
You don’t have much experience with alcoholics, do you? Lucky you.
The physical addiction is easy to kick. A few weeks and your body is clean. I don’t know how often my mother claimed she’d “made it” because she hadn’t drunk alcohol for a few weeks. The psychological addiction is the hard part and every time you fail, it gets worse.
Now, secular, medicine based treatment acknowledges that you need on average 10 attempts to make it (and that many people actually don’t survive that long).
What do you think, what will make it easier to try again? An approach where the fact that you relapsed is an expected result of your disease or an approach where the fact that you relapsed is a personal failure?
Modern medicine is amazing at treating the body. We’re still pretty bad at treating the mind.
@19 Thanks for your comments. It’s not just courts forcing AA on people. Professional medical organizations with control of licenses also force this unscientific treatment on addicts. One would think that the medical community would have a better handle on treatment options.
My sister, a dentist with her own practice, is an alcoholic. After a suicide attempt, she voluntarily turned herself in to a state organization of professionals that are supposed to assist the dental community in crisis. This organization will report to the state licensing board if she does not follow their recommendations. She was sent to rehab and after treatment sent to AA along with various other psychiatric appointments. She’ll be monitored for 5 years. Forcing her into treatment and the monitoring are great things as they help her stay on track. But, as an atheist, she struggles with AA due to the religious component. She doesn’t buy into the idea of god and she doesn’t believe that a doorknob can be her higher power either. The concept is so nebulous as to be useless. It’s a bullshit aspect of her ‘treatment’ plan that wastes her time and adds another burden of sitting through quasi-religious meetings. It’s infuriating.
Sounds like AA is succeeding the same way the weight loss industry does – sell a program which is “guaranteed to work” if followed exactly, and then explain that the person who was experiencing failure can’t have been doing it right. Meanwhile you’re causing harm.
Chronic dieters essentially train their bodies to become more efficient at processing the calories from food – making it easier and easier to gain weight no matter how little you actually consume. But of course, if you’re a fat person and you say you’re exercising strict portion control but still putting on weight, you have to be lying (because it couldn’t possibly be a known side effect of having been on various weight control schemes for over a decade or anything like that), and it’s your own fault you’re fat, rather than a perfectly predictable side effect of a known adaptation of the human system. (Dieters tend to be chronic – again, the success rate at losing weight and keeping it off is about 5% long term, for values of “long term” which equal “2 – 5 years”… so there’s lots of repeat customers).
I suspect if you’re the sort of alcoholic who is drinking to deal with an undiagnosed (and unacknowledged) low-level mental illness (particularly if you’re from a social background where mental health treatment is either highly stigmatised or just plain unaffordable) then you’re in a position where AA is pretty much the only option you have. Now, I’ll admit, I’ve not used AA’s program. But I have been involved with a twelve-step group based on their method (this one for actual mental health problems). Yeah, it was good as a way of getting started on dealing with a serious mental health issue – but it was also a major stumbling block in the way of me actually going and getting proper treatment from a psychologist, because there was a strong culture of “this is better, this was designed by mentally ill people, this is soooo much better” within both the group and the people running the overall program. Twenty years later, and after a fair few breakdowns on my part (for which I beat myself up, because I had the Blue Book and I knew the GROW program, and I should have been “better” than that, and I shouldn’t need anti-depressants or visiting a doctor oh gods I must be sicker than I thought if I need those…) I got actual therapy from an actual therapist, and I’ve found that helps a lot more.
One size does not and should not fit all.
Two observations, re AA. First, it seems that the people I’ve known who’ve quit successfully almost always go through at least one month at an inpatient/residential facility. Meetings several times per week don’t seem to do the trick on their own. What this means is that you have to be reasonably well off, or have first rate corporate insurance (and an indulgent boss), to get to a place and stay there for a month or two.
Secondly, the implicit abdication of personal agency bugs the shit out of me. Anything bad that happened pre-quitting was That Debbil Alcohol’s fault, and any successes post-quitting are God’s doing. Whoa, Nelly, where is the person in all this? At that party where they stole all the silverware or dropped a deuce in the closet or pawed at their best friend’s wife, EVERYBODY was drunk, but only one person was a total asshole. You absconded with the family savings and spent it on hookers and blow over a three week binge in Panama? And you’ve got the chutzpah to tell us that it was alcohol’s fault, and not your own??? You smacked your wife and kids around, and are blaming Budweiser???? Go fuck yourself.
On the other side, if you’ve gotten your act together and finally bothered to show up at work and are getting anger management counseling, whatever, credit yourself, not some Fuzzy Canaanite Sky God and his skinny little son. Pat yourself on the back, and keep up the good work.
But the shitty stuff you did was YOUR fault, and the good stuff you do is to YOUR credit. Stop beginning all your excuses with “well, when I was drinking”, and ending all your success stories with “only by the Grace Of Gawd”.
As a recovering addict, I hate AA and NA. This time around I have been clean since 1.22.15 and last time it was about 9 years. Anyway, I have never had a counselor that didn’t push AA or NA, even though the folks at our hospital run rehab seem to fail at the same rate, whether or not they attend meetings. I think they can be good if you have nobody to turn to when you feel lIke using as you can find a meeting almost any time around here, but that’s about it.
Also, I have been to a ton of different meetings and they were all very churchy. Lots of praying, lots of dumb spiritual quotes, lots of “giving yourself over to your higher power”. They always ended with the serenity prayer (though, so do all my groups at the hospital rehab I attend).The most condescending part to me is how they pretend your higher power can be anything, like that is all it takes not to alienate secular people. “Your higher power can be a bush or a chair, it can be anything! It’s not necessarily god!”. So somehow a rock is supposed to be my stand in for your man in the sky with which you claim to have such a deep relationship and find all this strength? Uh, come again?
I will say my dad got sober with AA after a zillion tries, and has been for nearly 20 years. He stopped going after the first year and has done well with antidepressants, a steady job, and a supportive family.
The spontaneous recovery rate for untreated addicts is quite high (as work on Vietnam veterans who were heavy heroin users in Vietnam and other groups shows- drug abuse typically resolves as people approach their 30’s). There are some comparative studies of 12-step programs– look them up on the Cochrane Reviews site. Brief counseling does better than 12-step, which is equivalent to no-treatment. But courts often order 12 step treatment, despite the lack of good medical evidence for its effectiveness (there’s a political history there). I’m directing an MA thesis on this material (oral next Friday), and the work my student has done is a devastating critique of the history, politics and medical failure of 12-step programs, not to mention the horrific abuse and even brain-wishing methods used by some extreme examples (funded by the US government s part of the war on drugs). Look up Kids of Bergen County for example…
“I’m also an alcoholic who, thanks to AA, has been sober for the last 24 years.”
Of course and I know a lot of people who “thanks to God” have been healed from their illnesses. That’s just your subjective feeling of a cause that you cannot possibly know.
Regardless it is great that you have been sober for 24 years. Congratulations.
I would be interested in that thesis professionally. PZ has my email if you like to get in touch.
Friend of mine, female, same age, used to drink half as much as me, is now nursing home material, in nappies and a total mess due to alcoholic liver cirrhosis. What societies, and individuals, can’t afford is ineffective solutions to this epidemic problem.
Same as with homeopathy, the evidence that AA doesn’t work has to be communicated to the political decision makers effectively.
This post reminds me of an article I just read by Emily Braham that describes a quiet movement to popularize the non-alcoholic lifestyle.
@11 Usernames! (╯°□°)╯︵ ʎuʎbosıɯ
I find your statements here a little too forceful. From the point of view of conducting a trial or study into AA, there are definitely unique problems. It’s basically straight out impossible to study it in a randomly controlled way the way one would with antidepressant. That said, AA is studied, much of it published in the usual peer reviewed manner. These offer at least something to work with.
Cochrane, which conducts meta analyses for health professionals, in 2006 found regarding AA that “experimental studies have on the whole failed to demonstrate their effectiveness in reducing alcohol dependence or drinking problems when compared to other interventions.”
An updated review is currently being worked on which is hinted will give a slightly warmer response to AA.
The reality here is more nuanced than the way you describe it. The data we have on AA, while lacking in several aspects, is still certainly better than nothing.
Another key problem here is that AA occupies a hegemonic position in the West (less so outside the USA). There is a huge gap between the perceived effectiveness of AA in society in general (very high) and what we can actually determine from people who use AA or other Twelve Step Facilitation. AA is continually endorsed in direct and indirect ways by the media, while not giving a true picture of the options available for alcoholics. Science is coming up with numerous more effective options for treating alcoholism every year, and that alternatives exist for the many people who find AA religious.
It’s also much easier than you say to set an objective benchmark for measuring success in recovery. Alcoholism (diagnosed psychiatrically as Alcohol Use Disorder) is a spectrum disorder which can be measured according to severity. Given this it’s perfectly possible to measure changes in its severity, or eventual remission entirely.
Lastly:
You know as well as I do the entrenchment of AA in the establishment treatment position within the United States. One cherry picked quote from the latest edition of the AA Big Book doesn’t even begin to accurately present the large, verifiable and persistent problems AA has created for alcoholics: there are better ways to address alcoholism which are far more effective than sending everyone to church basement AA meetings, but these are being drowned out in the United States precisely because of AA’s current dominant position.