"Group's
spiritual element troubles atheists, agnostics.
By
Melissa Fletcher Stoeltje, mstoeltje@express-news.net
Michael
is a recovering alcoholic. Though he attends Alcoholics Anonymous,
Michael struggles with the program's spiritual element. He would
prefer to join a support group without the religious overtones but
one does not seem to exist in San Antonio.
As is
tradition on this day, people are busy forming resolutions to make
2012 better than the year now receding in the rearview mirror.
For
people with alcohol and drug problems, this might entail joining a
group like Alcoholics Anonymous. According to AA doctrine and its
12-step program, redemption from the disease comes not from willpower
but from reliance on a “higher power” — as Step Three puts it,
“God as we understood him.”
This
is where things get dicey for some alcoholics and addicts who are
atheist or agnostic, especially if they've been mandated to attend
12-step groups by the courts. Why should they be forced to sit
through meetings that violate their own secular beliefs?
In
recent decades, mutual-help groups such as Smart Recovery, LifeRing
and Secular Organization for Sobriety have formed across the nation
to offer support without spiritual concepts, but they've yet to make
their way to San Antonio.
Members
of AA say their program isn't religious — it's spiritual. A
member's higher power can be anything they choose — God, Jesus,
Buddha, the power of love, even AA membership itself, which exceeds
more than 1 million people in the U.S. alone.
At
free meetings throughout San Antonio each week, there are generally
no sectarian references, which are considered taboo since it violates
AA's big-tent approach. Still, most meetings end with a group
recitation of the Lord's Prayer, the provenance of which is
Christian.
This
practice alienates some nonreligious members and potential members,
as does the whole higher-power concept and what can sometimes be a
preponderance of generic “God talk” at meetings.
“It's
a bit of a problem,” said Michael, 53, who is gay and an atheist.
(In keeping with AA's tradition of anonymity, only first names are
being used.) He attended his first AA meeting here in 1999, one aimed
at gay and lesbian alcoholics. His drinking had become daily, which
worried him.
“But
people were talking about going to jail, having blackouts,” he
said. “I thought, ‘I don't have these kinds of problems.'”
Still
concerned about his drinking six years later, he returned to the
meeting. When it ended with the Lord's Prayer, Michael vowed to never
go back.
But
then some mornings, he found he needed a drink to soften a hangover.
Eventually, Michael returned to his old group but still felt out of
place.
Recently,
he found an AA group he likes, which he uses as his higher power. So
far, though, he's only been able to go four months before relapsing.
He admits he hasn't followed AA protocol, such as getting a sponsor,
someone who guides a newcomer through the steps.
“If
there were secular options, I think I absolutely would stick with it,
and I believe a large number of people would as well,” he said.
“But somebody has to start it.”
A
different approach
In the
1980s, secular alternatives did begin to form. Smart Recovery, the
most well-known with 2,000 members, is based largely on
cognitive-behavioral therapy, a counseling approach that seeks to
change maladaptive thoughts and behaviors. In the free SR support
groups, which take place in person and online, members are taught
ways to cope with cravings, stay motivated and live a balanced life.
Unlike
at AA, they're told they can conquer alcohol or other addictions
without help from above.
“Some
people aren't comfortable with the idea of powerlessness,” said
executive director Shari Allwood.
“Addiction
can be overcome,” she said. “We don't expect you to attend
meetings for the rest of your life. You can put these tools to use in
your life and move on.”
Some
SR members don't believe alcoholism is a disease — the prevailing
medical view, given the role genetics plays in some, but not all,
cases of alcoholism and for the physical changes in the brain that
happen during addiction that never fully go away and make it hard to
quit and stay sober. Personal choice plays a role as well.
Groups
like Smart Recovery are minuscule compared with the mammoth AA. “It's
a Catch-22,” said Dr. John F. Kelly, assistant professor of
psychiatry at Harvard Medical School. “Because the alternatives to
AA are so small, clinicians are reluctant to refer patients there.
And most of the evidence so far (regarding effectiveness) has been
about AA.”
Contrary
to AA's critics, a growing body of research shows that for many
people with alcohol use disorders, AA is effective. One study found
that of patients who regularly attended AA after alcoholism
treatment, about half remained abstinent after one year. Many who
weren't at least cut their consumption.
“
For
those who want to change their drinking behavior, AA can be an
important resource, as can other mutual-help organizations,” said
Dr. Robert Huebner, acting director of the National Institute onAlcohol Abuse and Alcoholism Division of Treatment and Recovery
Research.
At
this point, there are few studies showing the efficacy of AA
alternatives. Existing ones are of poor quality, mainly due to small
sample sizes, Huebner said. But new studies are under way, including
an NIAAA-funded one of Smart Recovery.
‘How
it works'
Dedicated
12-step members don't need studies to convince them the philosophy
works: Their redeemed lives are proof enough.
Still,
AA may not be suitable for everyone, some experts believe.
“The
single best predictor of whether or not someone will go to AA is the
severity of their drinking problem,” said J. Scott Tonigan, a
researcher at the University of New Mexico. “The more you've lost
control of your life, the more the 12-step message resonates.”
But in
the last 20 years, researchers have found that alcoholism — once
considered an “all or nothing” disease that invariably worsens
over time — actually lies along a continuum.
“People
with alcohol use disorders have mild, moderate and severe forms of
the disorder, with the majority of people experiencing problems in
the mild-to-moderate range,” Huebner said.
“This finding has major implications for our treatment system,
because the focus traditionally has been on people with disorders at
the most severe end of the continuum.”
So
it's not a question of AA or Smart Recovery being better or worse,
said Keith Humphreys, professor of psychiatry at Stanford School of
Medicine. It's a question of fit.
“People
in Smart Recovery tend to have more education, better jobs, less
severe (drinking) problems,” he said. “The narrative of
self-control resonates with them: They haven't been lying in the
street. They go to an AA meeting and think, ‘That's way worse than
anything that's happened to me!' This is true for a lot of people,
particularly high-bottom drunks. They may be happier in Smart
Recovery.”
A
“bottom” refers to an incident, usually dramatic, that prompts an
alcoholic to accept he or she must stop drinking.
But
how does AA, which has its roots in religion, psychology and
medicine, “work?”
Many
recovering alcoholics say their higher power played the main role.
Cathy, 61, a retired business executive, said she was a “hopeless”
alcoholic who tried willpower, traditional psychotherapy and
self-help books for years to no avail.
“I
couldn't live without alcohol, period,” she said. “I didn't lose
my house or my husband, I didn't have DUIs. But there was a complete
emptiness inside, a spiritual malady. I had lost my soul. And only my
relationship with my higher power, whom I choose to call God, was
able to fill that hole.”
Scientists
theorize that AA works mainly by using a layman's version of
cognitive-behavioral therapy, complemented by social connection. They
note the many parallels between AA's approach and the psychological
one.
“(Members)
say prayer and meditation help them; scientists call that a cognitive
exercise in coping mechanisms,” Tonigan said. “You say the
Serenity Prayer when you're angry; in cognitive-behavioral therapy we
call that rehearsal training. Changing ‘playmates and playpens' in
AA is called avoiding triggers in CBT.”
One
large study found it is the social component of AA — going to
meetings, having a sponsor — that is most beneficial to most
alcoholics, more so than the spiritual practices, said Harvard's
Kelly.
“Prayer
and meditation only seemed to be an explanatory effect among the most
severe members, although they also benefited from the social
network,” he said.
The
law has gotten involved in the debate. Federal courts across the
country have ruled that judges can't mandate DUI or drug offenders to
attend AA or related 12-step programs as part of probation if they
object on religious grounds — a suitable secular alternative must
be provided. It's a church-state thing.
Lisa
Graybill, director of the ACLU of Texas, said her office regularly
gets complaints from nonbelievers ticked off because they've been
ordered to 12-step programs, but so far none have resulted in
litigation.
In his
23 years at the Bexar County probation office, assistant chief Abel
Salinas said he hasn't heard of a single probationer objecting to a
12-step mandate on religious grounds. When asked to provide a list of
local secular alternatives, he offered fee-based drug-education
classes at driving schools.
But
12-step waivers are rarely granted, said Salinas, and only to
defendants who can prove beyond doubt they cannot attend meetings for
legitimate reasons, such as work schedules. A defendant must ask for
alternatives to 12-step; it's not offered by the courts.
“Everyone
would try to get out of going,” he said.
The
Center for Health Care Services offers nonspiritually-based support
groups, but hey're open only to clients enrolled in its
addiction-treatment programs.
One
local criminal defense attorney who wished to remain nameless because
he regularly appears before judges here, said those who object to AA
on religious grounds are aware of the risk in voicing such concerns.
“The
problem is judges hold so much power,” he said. “Are you going to
tell the person who holds your fate in his hands that you don't want
to go to AA? (Judges) can make your life really hard, and the goal of
most people is to stay out of ... jail, no matter the cost.”
Interestingly,
studies show atheists — if they commit to AA — tend to fare as
well sobriety-wise as believers.
That's
the tack Suzanne, 75, took four years ago, when she joined an AA
group in Austin geared to atheists and agnostics. She said she keeps
her focus on working the steps and practising the AA principles —
humility, rigorous honesty, service to others — and lets the
spiritual stuff work itself out.
“I
realized that maybe my definition of spiritual was too narrow,” she
said. “One meaning of spirituality is the immaterial. I mean, you
can't see love.””
Comment:
Just a reminder that we haven't cornered the market in alcoholism
treatment! AA is not necessarily the most appropriate course for all who suffer from
this condition
Moreover
- How It DOESN'T Work:
endorsement
of (and participation in) any court mandated (chit system) attendance at AA meetings (a
breach of our own traditions);
overt
sectarian religiosity exhibited by AA groups (but not by individual members) (yet another breach of our
traditions);
our
failure to clarify the distinction between 'spiritual' and
'religious', and communicate this adequately to the general public.
This is easily remedied viz:
“
Spirituality
can refer to an ultimate or an alleged immaterial reality; an inner
path enabling a person to discover the essence of his/her being; or
the “deepest values and meanings by which people live.”
Spiritual practices, including meditation, prayer and contemplation,
are intended to develop an individual's inner life; spiritual
experience includes that of connectedness with a larger reality,
yielding a more comprehensive self; with other individuals or the
human community; with nature or the cosmos; or with the divine
realm. Spirituality is often experienced as a source of inspiration
or orientation in life. It can encompass belief in immaterial
realities or experiences of the immanent or transcendent nature of
the world.” [http://en.wikipedia.org/wiki/Spirituality]
Cheerio
The Fellas (Friends of Alcoholics Anonymous)
We
start by examining whether people's attachments to these three
identities are indeed in decline, beginning with religion. Here there
is little doubt that a substantial change has taken place, with a
marked decline in the proportion who describe themselves as belonging
to a particular religion. In 1983, around two in three people (68 per
cent) considered themselves to belong to one religion or another; in
2012, only around half (52 per cent) do so. As our Personal
relationships
chapter sets out, this decline is in practice a decline in attachment
to Anglicanism; in 1983 two in five people (40 per cent) said they
were Anglican, and the Church of England could still reasonably lay
claim to being England's national church (and thus, arguably, to some
extent its fount of moral authority). But now only 20 per cent do so.
In contrast, the proportion saying they belong to a religion other
than Christianity has tripled from two to six per cent. Britain's
religious landscape has not only become smaller but also more
diverse.[2]”
