The author of this article describes a psychological model, based on studies he and his colleagues have conducted, to clarify the operation of Alcoholics Anonymous (AA) and other movements that operate through social and ideologically grounded support and can be characterized as “spiritual recovery movements.”
Taken together, the findings from the cited studies make evident that peer-led ideologically oriented self-help programs illustrate the value of combining intense mutual support with the psychology of commitment to a health-related ideology.
Although peer-led self-help programs are not among the approaches employed by traditional psychiatrically grounded providers of care, their success underlines their potential value to mental health professionals who can make use of these programs to complement conventional treatment.
This would require the introduction of certain elements in professional curriculums, such as;
- an understanding of the psychology underlying these programs,
- an openness to the contribution of such programs to recovery from illness, and
- competency in referral to and even collaboration with these programs.
The current practice of psychiatrists and general medical caregivers does not reflect acceptance of these programs, however.
The author recommends that physicians in psychiatric residency programs should, as part of their standard curriculum, attend AA meetings, visit drug-free therapeutic community programs, and serve as co-leaders of peer-led therapy groups on ambulatory services.
Research report; Galanter, M. Alcohol and drug abuse: Healing through social and spiritual affiliation. Psychiatric Services, 53(9):1072-1074, 2002.
Brief-TSF is designed to address these issues.
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Drink – Drunk – Disaster – Discipline – Direction – Divine Aid
The Six D’s Pointing the Way Down and the Way Out
“Bringing Back the 75%-to-93% Recovery Rate to Real Alcoholics and Addictsâ€
Dick B.
Many Pathways: And Here’s the Old-School A.A. Path to Recovery and Cure God’s Way
A proven long-standing answer to relapse after relapse after relapse
A Simple Resource Guide
For physicians and psychologists, churches and clergy, hospitals and detox facilities, counselors and therapists, treatment programs and rehabs, law enforcement agencies and correctional officers, half-way houses and therapeutic communities, non-profit and government agencies, alcoholics, addicts, their families, and those with life-controlling problems beyond medical cure.
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“Bringing Back the 75%-to-93% Recovery Rate to Real Alcoholics and Addictsâ€
The Problem, the A.A. Answer, the Approach, and the Solution
Their plight of A.A. pioneers was as follows: (1) All were problem drinkers—“real alcoholics,†as they were called. (2) All were drunkards—excessive, uncontrolled drinkers. (3) All suffered most of the disastrous consequences of alcoholism—jail, hospitalization, accidents, domestic problems, debt, disgrace, and ill-health. (4) All typically repeated and repeated and repeated to the point of self-destruction the predictable consequences of their alcoholism.(5) Denial and dishonesty accompanied their persistence in the drink-drunk-disaster conduct—the very behavior that was destroying them
Alcoholics Anonymous was founded June 10, 1935 in Akron, Ohio. Its two founders (Bill W. and Dr. Bob) immediately began helping seemingly hopeless medically incurable real alcoholics willing to seek God’s help in a disciplined, directed spiritual program of recovery.
Within two years, forty men attained a documented 75% success rate in Akron; and in two more years, Cleveland pioneers grew from one group to thirty in a year and attained a documented 93% success rate.
To hundreds of news outlets across the United States, with but few exceptions, the recovered early AAs declared they had been cured of alcoholism by the power of God. Medicine and religion were astonished at the remarkable, miraculous results, and said so in the press, in endorsements, and in reviews.
The simple Akron approach took its basic ideas from the Bible. The Book of James was the favorite. The Sermon on the Mount furnished the underlying philosophy. And 1 Corinthians 13 specified the ingredients of love and service which were the essence of the spiritual program.
The pioneer program—developed in the summer of 1935, and carefully investigated about two years later–consisted of five simple elements which established the necessary relationship with God and cure.:
(1) Permanent abstinence. (2) Reliance on the Creator and coming to Him through Jesus Christ. (3) Obedience to God, eliminating sinful conduct and walking in love. (4) Growth in fellowship with God, and His son through Bible study, prayer, seeking God’s guidance, and studying devotionals and other religious literature. (5) Teaming together as witnesses to help other alcoholics get straightened out.
To these five disciplines, other practices were added: (1) Hospitalizing newcomers for several days. (2) Housing most of them in pioneer homes on their release. (3) Meeting together daily for quiet times with Bible study, prayer, seeking guidance, and discussion. (4) Reading Christian literature distributed by Dr. Bob and his wife Anne. (5) Attending a “regular†meeting once a week. (6) Choosing recommended social and religious comradeship with each other. (7) Choosing recommended weekly attendance at a church of choice.
Early AAs widely proclaimed that God had done for them what they could not do for themselves. They willingly accepted permanent abstinence and resisted temptation. They openly relied on the Creator for help, strength, and guidance. They adopted the discipline of changing disgraceful behavior to godly behavior. They recognized the importance of understanding of God, Jesus Christ, the Bible, prayer, guidance, literature, and daily devotions. They diligently worked at helping others. And their six D program produced predictable, widely acknowledged, remarkable results for those who really tried.
“Bringing Back the 75%-to-93% Recovery Rate to Real Alcoholics and Addictsâ€
The Situation Today
Statistical studies, albeit flawed and lacking in number, establish that today’s recovery approaches and programs are totally different from those in Akron and are most assuredly producing disappointing results. Efforts to deal with alcohol and drugs have abandoned the “God part†and have turned to pharmaceuticals, therapy, counseling, treatment programs, rehab centers, nutrition, behavioral and genetic research, and to the host of “Anonymous,†“12-Step,†“self-help,†and “mutual therapy†groups. But those scientists and writers doing government studies, grant-funded research, statistical surveys, and interviews have established a dismal picture today. First, in the halcyon days of the 1960’s to late 1980’s, insurance companies, employee assistance programs, treatment centers, government programs, and 12 Step programs backed by expensive and compulsory attendance. Their support was aided by the courts, by probation and correctional people, and treatment programs themselves. The “recovery†rage grew increasingly large. But then the failures and recidivism became rampant. Treatment centers closed. Recovery stores began vanishing. A.A. itself reached its one million member mark in the United States and stopped growing. “Recovery†surveys recorded relapse after relapse after relapse. And most skilled observers reported that there was an axiomatic 75% failure rate. Many actual surveys showed a much higher failure rate, to the point where perhaps as few as 1% were maintaining permanent sobriety, and probably no more than 7% could be counted as “recovered.†The word “cured†disappeared from A.A.’s literature, from treatment literature, and from recovery jargon. Worst of all, the word “God†was substantially replaced with “higher power.†The word “spirituality†replaced cure. The word “relapse†was accepted as a regular consequence of alcoholism and addiction. And the surge away from God, that has become so apparent in the United States, has become the norm in many many 12 Step meetings. So much so, that Christian and Church alternatives have attracted more and more people while A.A.’s growth has remained static and recovery rates have continued to plummet..
The Problem
Recovery has, despite all its failures, acquired a universalized and secularized complexion. This means that, for constitutional law reasons, for religious reasons, for money reasons, for growth reasons, for discrimination reasons, and for fear reasons, the role that our Creator played in early A.A. successes, stories, practices, and results has fallen largely between the cracks.
A Solution
History offers one answer. As God’s role, power, and cures vanish, the promise that with God nothing is impossible becomes dim in the drug and alcoholism battlefield. Choice is part of the answer. Alcoholics, addicts, those afflicted with life-controlling problems, and their families still have the very choice today that A.A.’s own basic text suggests: God either is, or He isn’t. They may choose not to believe or choose to believe in some “other†god or idol. They may choose to reject reliance on the Creator and still have innumerable other pathways available to them today. Choosing God’s help within the recovery scene neither condemns nor excludes the rights of others to choose and believe in other ideas or in nothing at all. However, rigid advocacy of secularism and universalism, doctrinal rule-making, and outright intimidation of religious expressions do drive believers away from their faith roots. You hear in recovery meetings, treatment, and therapy: You can’t mention God, the Bible, or Jesus Christ. “Religiosity†is labeled and ridiculed. You should only read religion-free “conference approved†literature. Often you are told that, to do otherwise, contravenes Traditions. Some say they go to church for their religion and to A.A. for their “spiritualityâ€â€”whatever that means. Information, dissemination, and choice need freedom.
“Bringing Back the 75%-to-93% Recovery Rate to Real Alcoholics and Addictsâ€
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A.A. Relapses, Successes, Cures
Dick B.
© 2008 by Anonymous. All rights reserved
http://www.dickb.com/index.shtml
Did Anyone Ever Think a Drunk Could Be Cured?
Every alcoholic knows about “relapses,†or “slips,†or “going out for research.†Some lay it to: “He stopped going to meetings.†Some lay it to his failure to “keep in fit spiritual condition.†Some lay it to sin. Some to the devil. Some to temptation. For my part, I would start by laying it experientially and factually to that strange exercise of free will which Bill Wilson called “insanity.†I characterize the behavior in terms of three D’s and an R. These are Drink, Drunk, Disaster, and Return. We alcoholics Drink. That means we get Drunk. That means we encounter Disaster. And, strange as it looks, we Return. We return to the very drinking, drunkenness, disasters, and return that got us into all the trouble in the first place. Dr. Bob often said it’s the first one that gets you.. In a moment of theological brilliance, Bill Wilson wrote: “If there was a Devil, he seemed the Boss Universal, and he certainly had me†(Alcoholics Anonymous, 4th ed., 11).
Yes, Bill, you may have called it right. But it was you, and it was Dr. Bob (your later partner), who each picked up the first drink, got drunk, encountered disaster, and yet returned for more. Some have inappropriately characterized this “insanity†as “doing the same thing over and over and expecting the result to be different.†No! The insanity involves doing the same thing over and over despite your knowledge that the result will be no different. The inevitable result is the same. It is not different. Disaster inevitably follows, and is followed by return. The first definition implies we use reasoning—“expecting.†The second definition puts out the fact that we have lost our reasoning and substituted “lunacy,†as Bill Wilson called it. Who but an obsessive nut-house case would keep doing the same thing over and over with proof beyond reasonable doubt that the result will be the same—disaster followed by return for more of the same.
Would there ever be a cure?
In the early 1930’s, most didn’t think so. Many believed a lay therapist Richard Peabody, who never relied on God, who said there was no cure, and who “proved†his point by dying drunk
Medicine said “no.†In fact, most in that profession still tend to say, “No.†There is no cure.
Religion often recognized the power of God to cure, but seemed puzzled by its own inability to reach the afflicted very effectively. Sometimes religion was puzzled even as to the nature of the malady itself—sin, or disease, or behavioral disorder, or genetic predisposition. That was strange since the Book of James, which became the favorite of early AAs, laid out the Biblical situation quite well:
Blessed is the man that endureth temptation: for when he is tried, he shall receive the crown of life, which the Lord hath promised to them that love him. Let no man say when he is tempted, I am tempted of God: for God cannot be tempted with evil, neither tempteth he any man. But every man tempted, when he is drawn away of his own lust, and enticed. Then when lust hath conceived, it bringeth forth sin: and sin, when it is finished, bringeth forth death. Do not err, my beloved brethren (James 1:12-16, KJV).
“Do not err, my beloved brethren!†The Good Book places a definite responsibility on the one tempted. It says that God can’t be tempted, and that God doesn’t tempt. Dr. Bob’s wife Anne Smith wrote in her journal that all thoughts come from one of three sources—God, man, the devil. James tells man not to err. And the Book of James at 4:7-10 goes on to describe the solution:
Submit yourselves therefore to God. Resist the devil, and he will flee from you. Draw nigh to God, and he will draw nigh to you. Cleanse your hands, ye sinners; and purify your hearts, ye double minded. Be afflicted, and mourn, and weep: let your laughter be turned to mourning, and your joy to heaviness. Humble yourselves in the sight of the Lord, and he shall lift you up (KJV)
Submit! Resist! Draw near to God! Cleanse your hands! Purify your hearts! Humble yourselves in the sight of the Lord! The devil will flee. God will lift you up. Here again the Good Book places responsibility on the one tempted. It is he who humbly must turn to God, submit therefore to God, resist the Adversary, believe that the Adversary will flee, and believe that God will lift him up. And out. Rev. Sam Shoemaker, writing about the James verses, said we sometimes need a “Divine Derrick†to lift us out. All these ideas were not only read, but favored, by early AAs—who wanted to call their fellowship The James Club. Much of such Biblical James language actually found its way into Bill Wilson’s Big Book. Look at these examples:
“Without help it is too much for us. But there is One who has all power—that One is God. May you find Him now†(Alcoholics Anonymous, 4th ed., 59). “We had to have God’s help†(62). “Being all powerful, He provided what we needed, if we kept close to Him and performed His work well’ (63).“God save me. . . Thy will be done†(67). “We trust infinite God rather than our finite selves†(68). “What is this but a miracle of healing? . . . He humbly offered himself to his Maker—then he knew. Even so has God restored us all to our right minds. . . He has come to all who have honestly sought Him. When we drew near to Him He disclosed Himself to us!†(57). “Burn the idea into the consciousness of every man that he can get well regardless of anyone. The only condition is that he trust in God and clean house†(98).
You can read my new title Twelve Steps for You, and see how the words of the Bible and Rev. Sam Shoemaker flow into such A.A. Big Book language. It should be quite obvious to you.
The A.A. Founders and Pioneers Clearly Believed Alcoholism Could Be Cured
Bill Wilson said:
Henrietta, the Lord has been so wonderful to me, curing me of this terrible disease, that I just want to keep talking about it and telling people (Alcoholics Anonymous, 4th ed., 191).
Dr. Bob Smith said:
But this was a man [referring to Bill Wilson] who had experienced many years of frightful drinking, who had had most all the drunkard’s experiences known to man, but who had been cured by the very means I had been trying to employ, that is to say the spiritual approach (4th ed., 180).
[Dr. Bob sought admission to the hospital for Bill Dotson—A.A. Number Three:] “ He phoned the nurse in charge of admissions at Akron City Hospital and told her how he and another drunk had a cure for alcoholism. . . The nurse had commented, ‘Well, doctor, you’d better give that cure a good workout on yourself’.†(RHS: Co-founder of Alcoholics Anonymous our beloved DR. BOB (The A.A. Grapevine, 1951), 6.
A.A. Number Three Bill Dotson said:
I thought, I think I have the answer. Bill was very, very grateful that he had been released from this terrible thing and he had given God the credit for having don it, and he’s so grateful about it he wants to tell other people about it. That sentence, “The Lord has been so wonderful to me, curing me of this terrible disease, that I just want to keep telling people about it,†has been a sort of a golden text for the A.A. program and for me (Alcoholics Anonymous, 4th ed., 191).
A draft cover for the First Edition of Bill Wilson’s Big Book stated that the Big Book provided the pathway to cure. And hundreds of AAs across the United States echoed this in statements reported in newspapers and magazines. Those articles can be found in a scrapbook available for purchase at A.A. World Services Headquarters in New York. See Richard K., New Freedom: Alcoholics Anonymous Reclaimed; and my titles Cured and When Early AAs Were Cured and Why (http://www.dickb.com/titles.shtml).
Cured. Cured. Cured. Anyone can find several hundred statements by our A.A. ancestors.
Their Documented Success Rates Were 75% in Akron and 93% in Cleveland
It is no secret that A.A.’s success rates today lie somewhere between 1% and 5%. These findings have been published in A.A.’s own membership surveys; by historians, scholars, researchers, and speakers; and by those active AAs who can see for themselves as they go to their various meetings and groups and watch their fellow alcoholics go out and get drunk. The “why†is debated. And, though it rankles many loyal AAs to hear it, the simple fact is that the A.A. of today is not the A.A. of the pioneers—not in any way, shape, number, or form. The change has perhaps best been studied and depicted by Massachusetts historian Richard K. in his four research titles—particularly his New Freedom: Alcoholics Anonymous Reclaimed.
What about the 75% and 93% figures?
The Documented Akron 75% Figures: This frequently stated percentage figure still rankles some A.A. loyalists today. Not me. I know what has worked for me. I have always liked the Big Book statement: “Rarely have we seen a person fail who has thoroughly followed our path†(p. 58). Path to what? The path to a “relationship with Godâ€â€”the “Creator†as Wilson so often called Him (pp. 28. 29, 72, 164). Bill added: “If a repetition is to be prevented, place the problem, along with everything else, in God’s hands†(p.120). Does that really bother the scientists and researchers? I have no reason to suppose that God was any less powerful today that He was at the time of the Akron fellowship program of the 1930’s. Truth cannot and should not be replaced with resentments. If you don’t like the word “God,†that’s your resentment. If you deny what the Big Book states—God can and will do for you what you cannot do for yourself—that’s your subjective reaction (Alcoholics Anonymous, 4th ed., pp. 11, 60, 84). The facts show that early AAs in the Akron Fellowship, who really tried, had a documented 75% success rate among seemingly hopeless, medically incurable real alcoholics who went to any lengths to establish and maintain their relationship and fellowship with God. See Alcoholics Anonymous, 4th ed., p. xx; RHS, p. 8; The Language of the Heart, p. 10; DR. BOB and the Good Oldtimers, pp. 129-31; Richard K., New Freedom; and Dick B., When Early AAs Were Cured and Why.
Snipers attack these 75% cure and success rates. But the snipers just don’t produce the documented evidence that contradicts the records. Sometimes, they point to evidence which is irrelevant—the drinking experiences of some of the pioneers who did get drunk and died. But many of those who did get drunk were simply not among the first forty. (And as the statistical summaries plainly stated, twenty-five per cent did get drunk—something that is irrelevant to the seventy-five percent figure). Sometimes revisionists argue that many—who gave it a whirl along with the original forty pioneers—were rim-runners—people who were just shopping or were just “be-backers,†or were just “compulsory†visitors even in those early non-court ordered days. Accuracy requires the admission that both the successful and the rim-runners were screened. That some failed, for one reason or another, can be demonstrated from the very rosters that list early AAs’ sobriety dates, relapse histories—where they occurred, and dates of death. But many a study points unerringly to the seventy-five percent among the forty pioneers, whose record was described as follows:
“Of alcoholics who came to A.A. and really tried, 50% got sober at once and remained that way; 25% sobered up after some relapses, and among the remainder, those who stayed on with A.A. showed some improvement†(Alcoholics Anonymous, 4th ed, p. xx).
Forty Members Versus Two Million Members: I well remember a conversation I had some years back with Frank Mauser, the second archivist at A.A. General Service Office in New York. Frank had suggested I write a book. He helped me with my research at Stepping Stones and at GSO. He corresponded with me frequently and talked with me by phone. He spoke at a history conference I organized; and he let me stay in his apartment in New York when I was researching there. Frank once said to me, “Dick, A.A. is not just about forty pioneers.†And if we look at its two million world-wide membership today, that is certainly true. Frank worked for all of us and never worked for the first forty. But keep this in mind: Early A.A. was all, and definitely, about forty pioneers—half of whom got sober at once and remained that way, and another quarter sobered up after some relapses. Also keep in mind that just before A.A. began, most of these had been pronounced “medically incurable.†Even page 43 of the latest 4th Big Book Edition underlines the situation in speaking of a professional:
“One of these men, staff member of a world-renowned hospital, recently made this statement to some of us: ‘What you say about the general hopeless-ness of the average alcoholic’s plight is, in my opinion, correct. As to two of you men, whose stories I have heard, there is no doubt in my mind that you were 100% hopeless, apart from divine help.’â€
What a miracle it truly was, in the early years. With “divine help,†in the hands of the Creator, by the power of God, 75% were able to say that they had been cured by the power of God. Seventy-five percent! If you are wondering who they were, just go to Dr. Bob’s Home in Akron and look at their pictures on the wall. Or go to the Griffith Library at Bill Wilson’s birthplace and look at the rosters which contain their names, sobriety dates, and recovery records. Reflect on this: If, today, forty people with Aids or cancer or polio were given a vaccine or a cure, and if thirty wound up cured, would we be talking about the 75% success rate or the millions who never took the vaccine and were never cured. As one A.A. Grapevine article about cure put it, The A.A. “medicine†was God. People flocked to it once they learned the facts. And the successes of the forty became the standard between 1935 and 1938. And the cure became the golden text (4th ed., p. 191).
The Documented Cleveland 93% Figures: In A.A.’s own literature, you will find that in May, 1939, Clarence Snyder (one of Dr. Bob’s sponsees) started a new group in Cleveland for alcoholics only. He took with him the Big Book, the Twelve Steps, the Bible, and the Four Absolutes—Honesty, Purity, Unselfishness, and Love. Bill Wilson said that, after a year, the Cleveland AAs had grown from one group to thirty. And A.A. literature reported: “Records in Cleveland show that 93 percent of those who came to us never had a drink again†(DR. BOB and the Good Oldtimers, pp. 211, 261). If you want to know how that was done, read the following book by three old-timer sponsees who reported on Clarence’s program. See Three Clarence Snyder Sponsee Old-timers and Their Wives. Compiled and Edited by Dick B. Our A.A. Legacy to the Faith Community: A Twelve-Step Guide for Those Who Want to Believe (Winter Park, FL: Came to Believe Publications, 2005) ISBN 0-9767292-0-2.
Are the Early Years and Cures Important?
I believe there is no point here in arguing whether or not you can get well without A.A.
Of course you can.
But it’s very important to point out that insurance company records, treatment center failures and reorganizations, recidivism and relapse rates, and the obvious and acknowledged departures from A.A. groups and meetings show there’s been a very disappointing change.
The early program was very simple. It had no Big Book. It had no Steps. It had no Twelve Traditions. It had no world-wide service structure. It had no “trusted servants.†It did observe the five points reported to Rockefeller and to AAs by trustee-to-be Frank Amos: (1) Abstinence. (2) Reliance on the Creator. (3) Obedience to His will through walking in love and eliminating sinful conduct. (4) Growing in fellowship through Bible study, prayer, seeking guidance, using religious literature and devotionals. (5) Helping other alcoholics get straightened out.
You won’t find that program in wide use within Twelve Step Fellowships today. Not even among many other recovery efforts. There’s a new emphasis—Pharmaceuticals, drug courts, government grants, statistical surveys. Today we watch celebrities going into plush treatment centers and returning to old addictions. We find treatment programs talking about dual, poly, and other addictions. We find insurance companies limiting rehabilitation. But we also still find many in medicine and religion recommending A.A. as one alternative—an alternative that does not utilize the early program with the astonishing successes..
Is this shift away from history important? I think so. Anyone in a doctor’s office, a church, or a recovery meeting ought to jump at the chance to see what those early A.A. pioneers did that produced such an astonishing success record and propelled A.A. into a world-wide popularity as a source of recovery. They also need to heed Dr. Bob’s reassurance about the solution: “Your Heavenly Father will never let you down!†(Alcoholics Anonymous, 4th ed., p. 181).
Gloria Deo
dickb@dickb.com