An interesting paper about AA

[navysteve]

http://www.bhrm.org/papers/AAand%20DiseaseConcept.pdf

[laurie6781]

Thank you Steve. I believe this was originally published in late 2000 or 2001 and I do remember reading it before.

I have bookmarked it as I want to read it again (I just read it all, lol).

I would hope that the majority of folks here at SR take the time to read this article.

I am glad you posted it here, again thank you so much.

Love and hugs,

[Puddy]

I dunno. Much ado about nothing for me. I'd rather read an elaborate paper pontificating on the solution by a recovered alcoholic than what the proper scientific term for my malady is. I must admit, I didn't read it all though. By page twelve I was bored to tears.

Just me though.

[tomvlll]

I think this stuff is very important. The Doctor's opinion was written in 1935. It would be logical for a newcomer to question whether it's still relevant in 2009.

You have coronary disease. To treat that you are placed in a room with millions of dollars worth of elaborate equipment with 10 specialists in lab coats.

YOu have alcoholism. YOU are placed in a dungy church basement with Joe the car mechanic, Jim the painter, and John the butcher.

Might not a newcomer think " Is THIS the best I can do?"

Without getting into a long story, I tell newcomers that although the Dr's opinion was written in in 1939, it still stands today in its substance.
This article supports that.

[navysteve]

I agree Tom, I also think it is interesting to look at why they used the term disease, and how that fit into the scheme of things. They also gave an interesting view of hospitals prior to WWII.

[tomvlll]

I know I get a little pedantic about traditions, but I try never to use the word disease in meetings.
I've asked this before on this forum, but as far as I know, the word term 'disease' does not appear in our literature.

[McGowdog]

Originally Posted by Puddy

I dunno. Much ado about nothing for me. I'd rather read an elaborate paper pontificating on the solution by a recovered alcoholic than what the proper scientific term for my malady is. I must admit, I didn't read it all though. By page twelve I was bored to tears.

Just me though.

I'm with ya Puddy. I made it to page 4 before I decided to put it aside.

Too much conjecture, posturing, assumption, speculation, and otherwise misplaced and wasted energy. It reminds me of an external force with a motive to discredit and derail a fellowship that's been around a fairly long time and is too elusive to pick apart and destroy... like the Washingtonians were.

Bill W. said A.A. is not a disease. Period. It's rather an illness or a malady.

Then to say A.A. is its members. Well, what's the motive here? Most people who come to A.A. do not do the work nor do they get and stay sober. Some aren't even alcoholics. Most alkies die and the hard drinkers get sicker, but can stay sober with or without A.A. if they really want to. I've seen many many people who are "institutionalized" in A.A. But I have a book that says that I can get and stay sober if I submit to and follow a few simple rules. And my experience says that it is so.

Alcoholics Anonymous is a book that was 1st published in 1939 and it's as true today (what we call the first 164) as it was back then and it will NOT change. It has some traditions to protect it and that's that.

So that, I think, is what every newcomer needs to know.

Now next topic.

As I understand it, this is the Alcoholism 12-Step subforum. The Big Book of Alcoholics Anonymous is what this thread is for as far as I'm concerned. If not, we need to get a subforum for it in here; not a "What 'friends of A.A.' think about the Program" forum.

[McGowdog]

Nobody in this article has the guts or insight to just see something for what it is and report it correctly.

Here's a summary of The Dr's Opinion; "I can't help you."

I don't understand where people came up with the notion that this is a 3-fold malady, either. From my understanding, it's a two-fold malady (mental and physical) of which we combat on the spiritual plane. In doing so, the mental obsession is removed and we are not fixed whatsoever on the physical plane. How, for example, is an alcoholic...recovered or any otherwise... any different morally than any other sinner on the planet? If I steal from you today, it's because I'm a thief, not because I drank too much booze. If I lie to you, it's because I'm a liar, not because I'm drunk or high. This paper leads me to more confusion.

I'm to page 13 now, as I've decided to offer it the benefit of the doubt. It so far seems like antiAA fodder. There was mention in there about Prohibition not being a "failure". That is something I cannot get my mind around in any shape or form. But I'll keep plodding along here.

There's mention in there of the spiritual approach and the mention of "disease" by the AAGV and the tendancy to use surgery as a last resort until later in the 40s... blah blah blah. Until some doctor comes out and "fixes" an alcoholic's liver/pancreas/brain so that they can be restored on the physical plane, I'll hear no talk of a professional/medical cure. I'm sticking with Dr. Silkworth's assessment, "We can't fix you."

It is from you gentlemen we learn that alcoholism is a complex malady; that abnormal
drinking is but a symptom of personal maladjustment to life; that, as a class, we
alcoholics are apt to be sensitive, emotionally immature, grandiose in our demands on
ourselves and others; that we have usually “gone broke” on some dream ideal of
perfection; that, failing to realize the dream, we sensitive folk escape cold reality by
taking to the bottle; that this habit of escape finally turns into an obsession

What?! They have derailed and that's why we don't read the AA grapevine, the stories in the back or the 12 and 12. The Book was meant to be read and experienced. That's it. Not studied or pondered. This is what comes of studying the A.A. Book.

[FightingIrish]

This might be off topic, but what the hell.

I read this as, the organization A.A. is its members. I hear a lot of crap from anti-A.A. folks who say, "well, A.A. says this, and A.A. told me that."

I think it's valuable to remember that no one speaks for A.A., and this is what I think they're trying to get at.

Originally Posted by McGowdog

Then to say A.A. is its members. Well, what's the motive here?

[McGowdog]

Well I found something I like in the article...

“Don’t take it too seriously: they were not applauding your ideas but your results. You see, they know that they have not had much luck with alcoholics, and they are grateful to A.A. for getting the alcoholics out of their hair.”

I would surely like to see how much money our "friends of A.A." are pulling down in the "Alcoholism Industry" today and how eager they are to "give that income up."

...and this!

If physicians or psychiatrists could not cure or even treat it, how could it be disease?

Bingo! Now you're getting it... some 70 years later! You physicians and psychiatrists CANNOT cure or treat it! That's the beauty of A.A.! We don't need ya!

Now go have an apple and call me in the morning.

Oh boy, now the 12 & 12;

One commentator suggested that this book “was A.A.'s New Testament -- bringing to fruition the original revelation of the Big Book, Alcoholics Anonymous (Kurtz 1991, p. 124)

In my group, we don't no stinking "New Testament." The 12 & 12 concludes and explains. The Big Book needs no conclusions nor explanations. Just go do it and see what happens. Then share your experience with other alkies. That's all that's necessary. I think Dr Bob told Dub to "Keep it simple" and not louse this up. I don't think Dub listened.

A.A. may be this or that, but it would have been nothing without this... which Bill W recounts on a 1st visit to Dr Bob;

Even though he could not make them work, he already knew what the spiritual answers were.
What really did hit him hard was the medical business, the verdict of inevitable annihilation.
And the fact that I was an alcoholic and knew what I was talking about from personal
experience made the blow a shattering one (AACA, pp. 69-70).

[McGowdog]

Now this;

and (2) that “the inescapable fact is that there is no agreement among members of the medical profession about what it means to say that 'alcoholism' is a 'disease,” citing E. M. Jellinek’s book on the topic as its authority.

If y'all in the medical and/or legal profession want to call it a disease, have at it. I'll do my part and stay sober.

Now this;

Marty Mann... and others had worked to
portray the "typical alcoholic" as an industrious and conscientious person who was the
unfortunate victim of a disease. Supporting Powell, it was feared, could reinforce the down-andout stereotype.

Woah, and the politics rage on... all I know from personal experience is this... the practicing alcoholic is/can be very dangerous. Do what you gotta do to not cross their path or visa versa.

Then we get into the controversy of the "Hughes Act". Not like that guy broke any traditions, huh?

Now here's something Bill W. said that impressed me,

“I don’t like to see outside agencies just loaded up with A.A.”

Now this is no surprise to me;

In 1966, there had been fewer than 200 alcoholism treatment programs in US; by 1977, there were 2400; by 1987, there would be 6800 (Schmidt and Weisner 1993). Unsurprisingly, as A.A.’s own surveys would increasingly confirm, more and more people would come to Alcoholics Anonymous not at the suggestion of a physician or clergyperson but by way of a treatment program.56

So... 200 to 2400 to 6800... thus my use of the word "Industry."

Now... I'm starting to find this paper interesting. Nothing new, mind you, but interesting.

However people who needed A.A. got to A.A., they were of course welcomed. But treatment programs had two problems that in places led to a rethinking of that welcome. In the first place, after detoxification and education (which usually emphasized alcoholism-as-disease), what?
Experience suggested that the only way most alcoholics could attain lasting recovery was by
following the program of Alcoholics Anonymous. But A.A. could not be packaged, much less
sold, and the fellowship’s members were fiercely protective of the independence guaranteed by
their Twelve Traditions. We shall examine more directly some of these tensions between
Alcoholics Anonymous and treatment below, when we examine the later 1980s and 1990s.

Well duh.

Now this!

Treatment’s second problem involved its financing. Although popular celebrity alcoholics
were lessening stigma by making the headlines -- the late 1970s saw Betty Ford, Mary Tyler
Moore, and Jason Robards publically in treatment, and N.C.A. continued to sponsor periodic
celebrity “comings-out” -- most people did not have such financial resources. Nor did they have
health insurance that covered the costs of alcoholism treatment. Changing that became the top
agenda item of the treaters, and bringing about that change involved convincing medical and
insurance and especially public authorities as well as the public at large that alcoholism was a
Page 40 of 58
genuine disease.

Bingo again!

The effort was huge, and members of Alcoholics Anonymous, as well as
members of Al-Anon and anyone who had any however tenuous contact with treatment or
alcoholism, alcoholic or not, were mobilized into participating.57
Some did, but most did not, join the effort:

What a mess.

and lastly...

None of these stories reflect the changes just getting underway in the emerging “alcoholism field” -- the growth of the treatment industry and the
absorption of alcoholism into “addiction” conceptualized as something that could pertain to any
process or any person as well as to any substance.

I intuitively hate the word addiction when being referred to the alcoholic. Call me old school.

[McGowdog]

I'm sorry. One more;

does claim too uncritically and generically that “the disease
concept is implicit in A.A.,” his study appropriately emphasizes the disease concept’s history in
treatment. There was a difference, time had demonstrated, between the disease concept of
alcoholism, which helps alcoholics understand their condition, and the disease concept of
treatment, which seeks ways to term “disease” anything that might conceivably be labeled an
“addiction” for the “curing” of which someone might be persuaded -- or coerced -- to pay. ***

I'm sorry for my original assessment of the "paper" Steve. The more I read it, the more I realize there's a bunch of truth in this and that A.A.'s sordid history makes me feel even better about my "inbred" and not quite yet "underground" closed A.A. group.

Hah! I just cannot put this thing down!

A Final Glance via the AAGV
The AAGV, from 1976 on, tells a somewhat more complicated story, and from the nature of a
journal that selects what it publishes, part of that tale concerns what was unpublished. Since the
early 1970s, Grapevine editors rarely have found themselves short of submissions. Perhaps
surprisingly, since entries are published anonymously and without any remuneration, each month
sees an inflow of from 150 to 200 articles. The editors’ main task is selection. Beginning in the
late 1980s, they noted, more and more submissions mentioned treatment -- hardly surprising,
since more and more people were coming to Alcoholics Anonymous via treatment programs.
What struck the editors, however, was the increasing number of these submissions that talked the
language of treatment rather than that of the Twelve Steps, of “self-esteem,” for example, or the
“inner child.” Many seemed written by people unfamiliar with Alcoholics Anonymous. Of
interest here, these same submissions also tended to speak more directly and dogmatically about
alcoholism as disease.

BINGO!!!!!!!!! YET!!!!!!!!!! AGAIN!!!!!!!!!!!!!!!

The A.A. Big Book; one of the most talked about and studied books, but most seldom read and practiced books on the planet!

Huh Steve?

but even as a segment of the membership began
a “back to basics” movement that at times seemed a direct challenge to the very idea of a General
Service Office, many at G.S.O. responded by themselves retreating from new departures. The
great implicit fear was “rocking the boat,” and anything new and different threatened to do that.

Looks like you and I may not be so different. In any case, I've been accused, in here, of having an "inbred" group. So be it. Those of you that called me "inbred" can keep your "outbred" group. Just don't call it A.A. anymore.

Add: Ok, thanks for the article/paper afterall. It WAS a good read...once I plodded through the first of it. I'm off to a meeting.

[Cubile75]

Hey Patrick...

Thanx for your posts and Steve for the link. I like Dog's executive summary....

The two of you have done a service to many of us here... It is confusing for those of us who were indoctrinated in treatment centers then referred on to AA. I had a head start as my brother and my father (RIP) have been in the program a long time and did not go through treatment... My brother had a fit when he found out I was in rehab for two months...

AA's approach rings a bell... an illness.... yea.

Mark

[navysteve]

I had to re-read the paper myself Dog, and having spent alot of time reading research journals I found it to be a pretty good read.

As for sordid history...

There is no other kind of history.

The effort was huge, and members of Alcoholics Anonymous, as well as
members of Al-Anon and anyone who had any however tenuous contact with treatment or alcoholism, alcoholic or not, were mobilized into participating.57
Some did, but most did not, join the effort:

Members of AA practicing autonomy? Not getting in-line with the powers that be? Maybe this thing works after all?

AA historians give Marty Mann alot of power that she did not have. I think this paper in a small way illuminates this.

I don't get into the disease debate because I am armed with some facts. Our floundering fathers used the idea of a disease because you can treat it.

Second, the mid-1940s were medically a very different time than the late 1930s. The Great Depression had ended and the “medical miracles” of the World War II years had sensitized people to the benefits of intensive medical care.

A very important point that goes unnoticed.

[McGowdog]

I've got to admit the article/paper did something to me. In the beginning, I saw myself defending. Somehow, It drew me in and I kept reading. I didn't like what I was reading and I wanted to tear the article apart paragraph by paragraph.

Then I caught myself turning and wondering... Hey! I agree with some of this.

I'm just so inclined to defend the Program and a word like "disease" seems to be such an arguing point. But in the end, if the word works for you or helps you, hey. Why let it separate us? That's my ego in action.

Hate to say this, but I think I may try to print the thing off and read it again... like Laura said.