Alexander DeLuca, M.D.
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Reflections on Traumatic AA Experiences, AA-Bashing in MM, and Effective Communication of Deeply Held Ideas...

by DeLuca and 'Harry R.'; Excerpt from MM listServ 10/3/2004.. Posted 10/3/2004: [].

From: on behalf of Alexander DeLuca []
Sent: Sunday, October 03, 2004
To: MM-listServ; Harry R.
Subject: RE: AA and Science, was, Re: [MM] OT Magical Thinking

NOTE: [All names, except mine, have been changed, because it just doesnít matter Ė I was addressing the larger MM community by way of responding generally to a particular post from an MM member Iíll call Harry R.]

Good morning, Harry R.; good morning, MM,

Harry R. wrote:

"In point of fact, all scientific research on AA and 12 step programs have come to the conclusion that these are no better than no treatment at all. AA has zero scientific evidence on its side... What AA has is some fantastic salesmanship and ad-man hype coupled with a fair amount of brainwashing. OTOH, the Sobells demonstrated as far back as the 70s that controlled drinking programs yield results."

You know, Harry, these statements are a mish mash of intellectual criticism, some entirely accurate ("the Sobells demonstrated as far back as the '70s that controlled drinking programs yield results"), some exaggerated beyond the point of possibility ("In point of fact, all scientific research on AA and 12 step programs have come to the conclusion that these are no better than no treatment at all.").

Really Harry? Is it a "FACT" that "ALL" research on AA / 12-step self help groups has come to the "[SAME] CONCLUSION" that these "ARE NO BETTER THAN NO TREATMENT"??

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First of all, AA is not "treatment" and you grammatically assume/pretend they are, second of all there are very few "facts," in the area of addiction medicine at least, and third, it could not be true that all scientific research could come to the same conclusion about any real question in the world. But my point here is not to parse or argue finer points.

The point I want to make is that I think such a sentence is entirely unworthy of you, HR, who have demonstrated on these Lists rather prodigious powers of analytical thinking, and that you value precision in thought and expression, and honesty, and justice. What comes across to me is a person so enraged by a particular topic that he  can barely speak coherently about it, or a person who can speak coherently but with such intense and unpleasant emotional overlay that most other people can't stand to listen to it.

I am speaking, (as usual <alas> <sigh>), from bitter personal experience. For example, consider the next sentence of this email which starts out to be a qualification of the "personal experience" statement I just now made:

In my 'other life' I do advocacy work for pain patients, substance users/abusers, and the doctors who would minister to them, were it not for eighty years of brutalization from the Federal policeman (currently, the DEA) for attempting to do so.

See, even this one sentence about my work as an anti drug-warrior is dripping with sarcasm (anger), and uses words calculated to inflame like "brutalize." If I continued for a few more sentences in that vein, I'd be positively frothing. Why? Because I feel victimized and injured, personally and professionally, by the WOD and WOD thinking.

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It *IS* emotional for me. I do *hate* *them* - can't help it. And yeah, there is displacement onto the WOD of anger that would be properly directed, in my case, at individuals who hurt me as a child. Regardless of the particulars, this is a real problem in my life - ask my wife what it is like to be on the other side of me when I get on a good rant first thing in the morning over coffee before she is even fully awake. Not pleasant, not clever, not fun; in fact she feels attacked, and even knowing this I can barely resist, and very often indulge what is my experience/pathology at her expense, anyway.

And Harry, its not as if I am lying in the example sentence above -- I can, and have, defended my position on the WOD and submitted same for academic criticism and review. In fact, it was precisely that I was frustrated by my inability to discuss the matter civilly that I wrote, "The War on Drugs, War on Doctors, & the Pain Crisis in America: Eight Years of Naked Emperors" in June 2004, so I wouldn't have to discuss it, I could just point to my paper as all I really have to say, publicly, about the WOD.

These are the lengths I have to go to communicate at all about the war on drugs. It is sad, really, because I can't sit down and talk enjoyably with people about a subject I know very, very well, and regarding which I have a lot to share, because I always end up shouting and becoming angry. So I *must* communicate formally, or not at all, about the WOD.

And for this reason I try to be careful not to start or participate in WOD-related discussions here in MM, even though in a lot of ways there are relevant connections between the WOD and MM I'd love to discuss. But I know I can't have a spontaneous, civilized discussion in this area, and when I get angry people get hurt, usually mostly me.

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So if the shoe fits, wear it, Mr. H.R. I'm being way up front here that I may-be/probably-am just projecting my junk onto you; so if I'm off-base here, I apologize and please just disregard all this.

Regarding AA -
We have, in MM, many people whose experience with AA, or sometimes it is with treatment heavily inflected with 12-step 'philosophy,' has been traumatic; literally, psychiatrically, traumatic.

It is certainly true that there have been and will be "AA-atrocities" or "horrowshows," and Rebecca Fransworth (sorry if I'm getting the last name wrong) and others have put a lot of good effort into documenting and publicizing such both on the web and in print, I believe. Whether there is more or less "man's inhumanity to man" in AA compared to other segments of our culture, I do not know and do not now wish to argue. I can say that I attended AA meetings more than four times a week for consecutive years (like 4 or 5) followed by years of significantly lower intensity involvement (like weekly). Most of this was in the Bronx, NY but the latter years were in Putnam County, NY. I heard a lot of bad advice from people who shouldn't in my opinion be giving advice, but 'abused' or 'brutalized' I never felt, nor did I witness anything beyond what I consider culturally normal insensitivity. So I don't deny anybody else's experience, but let me be clear that I don't share your experience, for example Harry, and you need to understand that and respect that if we are going to do anything other than spew back and forth.

And then there are the cases where the attack on the individual is not from AA but is experienced in AA and will forever be associated with AA. For example, a person accused by the State of DUI is put through a terrifying experience in his arrest and jailing, and is then tried and threatened with loss of freedom of movement OR go to AA. Such a person is being terrorized, rightly or wrongly, by the State but will experience the trauma of the attack, going forward, in the environment of coerced-AA. I completely understand and respect and identify with experiences analogous to this, but I have not experienced State-sponsored coerced-AA, personally.

And so on.

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So HR, when you and other very smart people with whom I generally feel affinity here in MM, say stuff that implies "obviously anybody with a brain and any education at all would see through the irrationality and religious cultism of AA" - or whatever - I ask you to think about how people like me hear statements like this. I feel insulted, ignored, dismissed, and invisible. Because you know what, Harry R. and others? I consider myself pretty smart and very well read in this general area and I was an involved member of AA for over a decade. And I got a lot out of AA, and feel I helped a lot of other people through AA, and I think there are a lot of interesting aspects to AA that we could discuss in some other world. Because in this world you are too angry to think straight - or because you think me and others with experience similar to mine are idiots.

My take on AA, for what it is worth, is that it is a highly internally-consistent belief system that makes very good sense and which can be productively used in one's life, *but you have to be inside it, accept its basic premises, to cop the benefits or see its beauty.* And this phenomenon is not uncommon or weird, it is human.

For example, in the late 1970's I lived and worked for some years, while attending medical school in the Bronx, in an urban political commune called the Council for Social Development (CSD) in Philadelphia. We had a belief system based (no kidding) on Fritz Pearls' Gestalt Therapy, Albert Ellis's Rational Emotive Therapy, and Mao Tse Tung.  (One of the Philly papers referred to us, in a front page story headline circa 1979: "Mao'ish (sic) oriented leftist group defrauds State" [wasn't true <smile>]). CSD philosophy & lifestyle were highly internally consistent, made perfect sense to me who participated in "morning and evening center" aka twice-daily criticism/self-criticism sessions, and CSD was very productive in those years (free health clinic, day care center, jazz school and coffeehouse, radical film series, vending and construction and printing press business, etc etc). All of this the result of operating off a philosophy and lifestyle that struck most people in those years as bizarre and possibly sinister.

My point is that highly internally-consistent thought/belief systems are pretty common, Harry R. and others, and you probably cherish one or two yourselves, and it is a cheap shot, in my opinion, to stand outside of such a system and criticize it from the point of view of an often not-clearly-stated, entirely different, set of assumptions, assertions, and beliefs.

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Ultimately it is not about being nice, not about being respectful of others. I think I understand a little about where Harry and others are coming from regarding their negative AA experiences, and so I don't take it personally, and Harry and I remain, I trust, friends and comrades. But it *is about* effective communication of what one has to share to others in a community.

And let me attempt to be rigorously fair, and not quote out of context. Harry R. also wrote this sentence near the end of his post: "These questions get messy, and I know I can't solve them all in a single email," which I take as acknowledgement of a larger understanding of real world complexity which renders silly any dogmatic pronouncements on such matters.





Addiction, Pain, and Public Health website

Alexander DeLuca, M.D.

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Originally posted:  10/3/2004

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