Book Review… A study in Groupthink and the sheepish nature of man

Jan 19, 2020 Book Review…, News

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Book: The Sober Truth: Debunking The Bad Science Behind 12-Step Programs and The Rehab Industry
Authors: Lance Dodes, MD and Zachary Dodes
Critic: Glenville Ashby, PhD

‘The Sober Truth’ is a direct challenge to Alcoholic Anonymous (AA)’ 12 Step Program, a system that is widely considered the Holy Grail for treating addiction.

According to authors Lance Dodes and Zachary Dodes, high monetary stakes mask the verisimilitude of AA. While it is overly presumptuous to argue that there is a conspiratorial effort to ensure AA’s survivability, the reluctance to explore alternative treatments in the face of convincing evidence of its failure, begs the question: Why faithfully continue to endorse an unproven treatment?
No doubt, AA has its fair share of defenders at the frontline, proselytizers in a battle against intemperance.
But what was once a genuine attempt at salvaging victims of the bottle, has turned into a utilitarian movement hijacked by dogma and anecdotal confessions; but of scientific data to support the effectiveness of AA, there is none, not unlike the superannuated and spurious 19th century’s Keeley Remedy for the hopeless drunk.
To this day, “efforts by journalists to solicit data from rehabs have been met with resistance, making an independent audit of its [AA] results almost impossible, [thereby] leading to the inevitable conclusion that the rest of the programs either do not study their own outcomes or refuse to publish what they find.”
That dipsomania is curable through fate is thoroughly debunked by the authors.
How then did AA become the salve, the go-to solution endorsed by government and medical agencies? The authors traces the history of the movement from its inchoate stages, revealing a confluence of factors, from universal despair (from the ravishes of addiction), to evangelization and savvy marketing.
The authors record the movement’s unsettling beginnings.
“In 1939, the American Medical Association called AA “a curious combination of organizing propaganda and religious exhortation,” and that the one valid thing about [its Big Book] is the recognition of the seriousness of addiction. Other than this, this book has no scientific merit or interest.
”A year later, The Journal of Nervous and Mental Diseases called it “a regressive mass psychological method,” and “a religious fervor.”
But Bill Wilson (fondly referred to as Bill W.), the founding member of AA and now synonymous with the movement, never capitulated, such was his absolute faith in his system. Unbowed, he recruited believers with financial and political reach, figures like Dr William Silkworth who was so “impressed by Wilson’s conversion that he gave him free rein to circulate among patients,” and Marty Mann, a wealthy Chicago debutante who later formed the National Council on Alcoholism and Drug Dependence. They were both instrumental in keeping the organization afloat.
E.M. Jellinek who authored the “disease theory” of alcoholism, a model that was later disproven and disowned by Jellinek himself, was also critical to resuscitating a fledging movement.
Interesting is the picture presented of Bill W. He was a man torn by the impulsive forces of service and self-destruction, a man who, not unlike many members of AA today, simply substituted one addiction for another – his being chronic womanizing and cigarette smoking, with the latter finally leading to his demise.
Abandoned as a child and influenced by his once wretched grandfather who boasted of a spiritual conversion (not unlike biblical Saul) that cured him from alcoholism, Bill W’s worldview was steeped in dogma and religiosity.
Despite its jaded roots, “AA managed to survive, in part, because members who become and remain sober, speak and write about it regularly. “This is no accident, the authors remind us. “AA’s twelfth step expressly tells members to proselytize for the organization.”
They add, “Even people we who have no experience with AA may still have heard that it works or protest that 5 to 10 percent is a significant number when we’re talking about millions of people,” and “while it’s praise worthy that some do well in AA, the problem is that our society has followed AA’s lead in presuming that 12-step treatment is good for the other 90 percent of people with addictions.”
Clearly, AA has dismissed the psychology behind addiction, labeling it a disease while offering the Twelve Steps as the only solution.
Throughout, the authors decry the overriding culture of treating addiction.
“Rehab,” they write “owns a special place in the American imagination.”
They elaborate, “Unfortunately, nearly all these programs use an adaption of the same AA approach that has been shown repeatedly to be highly ineffective. Where they differ from traditional AA dogma is actually more alarming: many top rehab programs include extra features such as horseback riding, Reiki massage, and “adventure therapy” to help their clients exorcise the demons of addiction…Sadly, there is no evidence that these additional treatments serve any purpose other than to provide momentary comfort to their clientele, and cover for the programs’ astronomical fees, which can exceed $90,000 a month.”
Further, they pen, “patients begin using again soon after they emerge from rehab, often suffering repeat relapses…What’s especially shocking is how the rehab industry responds to these individuals: they simply repeat their failed treatments, sometimes dozens of times.”
Convincingly, the authors argue that the Higher Power of AA, central to recovery, places the addict in a precarious and potential psychological quagmire. “The relief [the addict is] afforded by the notion of a higher power is commensurate with the great disappointment one feels when the higher power turns out to be an illusion…”
Moreover, they posit that the movement is based on the false premise that members that have achieved sobriety are clinicians with the capability to help others. On the contrary, “these people are typically as fallible as anyone else, and even long-standing members can lapse or even withdraw from the program.” For the sponsee, inextricably bound to his or her sponsor, such a fall can prove catastrophic, “leading to the return of addictive behavior.”
The authors aver the case for understanding addiction through psychological lends.
The impulse to drink is symptomatic of a psychoanalytic problem that AA fails to address, hence, the astronomical rate of recidivism.
Addictive acts, the authors note, are nothing more than psychological displacements and that such issues are best explored and treated under the care of a psychotherapist and not by faith-based movements or programs that “apply community-based encouragement and little or no individualized care to treat emotional symptoms, including addiction.”
The failure of AA is understandable given its endeavor to address a psychological issue that it does not understand.
‘The Sober Truth’ is not merely an indictment on AA; it is a study in Groupthink and the sheepish nature of man, indolent and obdurate enough to shun reason in the face of compelling evidence. Surely, five to ten percent of AA members have triumphed over a presumable disease; but why, the authors reason, should we insist that the majority should be enslaved to a treatment that just does not work for them?

The Sober Truth: Debunking The Bad Science Behind 12-Step Programs and The Rehab Industry by Lance Dodes, MD and Zachary Dodes
Publisher: Beacon Press. Boston, Massachusetts
ISBN: 978-0-8070-3315-9
Available at Amazon
Ratings: Essential
Feedback: [email protected] or follow him on Twitter@glenvilleashby

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