Rational Recovery for alcoholics vs AA

[Floyd Cook]

Nothing later than ~ 2007 ?

Why do I not see any comments / posts much more recent than around 2007. ?.?.? Is this thread closed?

F.C.

 

[kirstenholme]

I also wonder if AA's 12-step program is founded on any science at all. I wonder if there are any scientific studies to support their assertions. I wonder if the 12 steps are just simply a modification of the 12-steps to become a better christian programs.

Since someone bumped the thread, I'll comment. No, the AA program is not based on any science at all. No, there are no scientific studies to support their assertions. Yes, the 12 steps were simply a modification of the steps of another Christian program--there was a spiritualist movement called the Oxford Group with five or six steps that were the direct foundation for the 12 steps.

AA is notoriously ineffective--the most commonly cited statistic is that one in ten get and maintain sobriety through AA but a Harvard study varies the figure according to length of sobriety and types of treatment. I can't track down the original studies but here is a link nonetheless:

http://www.orange-papers.org/orange-effectiveness.html#Harvard_Mental

These days there has been a merging of AA, Rational Recovery and SOS, so that those in AA tend to use the RR, CBT and SOS tools, and the latter certainly have elements that are similar to those of AA. The US supreme court has ruled three times that AA is a religious organisation, which means that people may not be legally forced to attend 12 step meetings as part of a rehabilitation program. People still appear to be sent to meetings by the courts, though. Perhaps it's a state thing. I don't know. I don't live in the US. Either way, RR and SOS have become a solution for alcoholics who can't tolerate the religiosity of AA. Regardless of how often AA might claim itself to be open to atheism, any short read through its texts will show that the attitude is rather, "We understand that you are an atheist struggling to believe in our Christian god. We once went through the same thing. Not to worry. Keep an open mind and one day soon you will have our beliefs."

 

[kirstenholme]

As I understand it, defining alcoholism as a disease was not supposed to be a scientific fact--if AA does purport anything intended to be scientific, it fails horribly, given its foundation of Christian spiritualism. The disease model intends instead to define the stages of alcoholism via the discredited Jellinek curve and to create a metaphor that supports lifelong treatment.

 

[Manopolus]

Is it just me, or does RR seem to be intended to function as a self-induced dissociative disorder? It appears to advocate mild insanity as a defense against addiction... not that this is really all that much different from AA, in my experience. Going completely bonkers in one way in order to "fix" another, opposing, problem seems to be the order of the day when it comes to addiction treatment.

I'm actually not all that sure that a "psychological addiction" exists in any meaningful way, BTW. Basically that part's just psychobabble for "what you've enjoyed in the past, you may decide you might enjoy doing again" as far as I'm concerned. If you combine that with an obsessive personality, it can be deadly, admittedly... so it has repercussions, but I don't know that "addiction" is even quite the right word for that part of it. It's more along the lines of classical behavioral conditioning over an extended period. I think that RR is close to getting it right in that particular part of it... it's not "unnatural" or a "disease" at all, but normal brain function that has gotten somehow twisted the wrong way.

 

[Dancing David]

Is it just me, or does RR seem to be intended to function as a self-induced dissociative disorder? It appears to advocate mild insanity as a defense against addiction... not that this is really all that much different from AA, in my experience. Going completely bonkers in one way in order to "fix" another, opposing, problem seems to be the order of the day when it comes to addiction treatment.

I'm actually not all that sure that a "psychological addiction" exists in any meaningful way, BTW. Basically that part's just psychobabble for "what you've enjoyed in the past, you may decide you might enjoy doing again" as far as I'm concerned. If you combine that with an obsessive personality, it can be deadly, admittedly... so it has repercussions, but I don't know that "addiction" is even quite the right word for that part of it. It's more along the lines of classical behavioral conditioning over an extended period. I think that RR is close to getting it right in that particular part of it... it's not "unnatural" or a "disease" at all, but normal brain function that has gotten somehow twisted the wrong way.

Hi,
I find your comments about RR very interesting as I recall nothing in teh book that supports this, now granted I read Trimpey's book a long way back and RR is an extensive organization.

My understanding was that RR was based upon one thing : the Big Choice 'Don't drink", so your comment about disassociation struck me as interesting.

I agree with you there is no psychological addiction, there is just addiction, which is a set of behaviors, some people have biological predispositions to certain substances and some substances have withdrawal syndromes.

But all addiction is addiction.

 

[mijopaalmc]

I don't know, I assume that like most predators they know where they prey is. NA would be violating the traditions if it affiliated with Co$.

There's NA, Nar-Anon, and NarcAnon, three different organization. NA (if, by NA, one means Narcotics Anonymous) is Twelve Step for addicts; Nar-Anon is Twleve Step for the families and friends of addicts; NarcAnon is a front for the Church of Scientology.

 

[TheGoldcountry]

These days there has been a merging of AA, Rational Recovery and SOS, so that those in AA tend to use the RR, CBT and SOS tools, and the latter certainly have elements that are similar to those of AA. The US supreme court has ruled three times that AA is a religious organisation, which means that people may not be legally forced to attend 12 step meetings as part of a rehabilitation program. People still appear to be sent to meetings by the courts, though. Perhaps it's a state thing. I don't know. I don't live in the US. Either way, RR and SOS have become a solution for alcoholics who can't tolerate the religiosity of AA. Regardless of how often AA might claim itself to be open to atheism, any short read through its texts will show that the attitude is rather, "We understand that you are an atheist struggling to believe in our Christian god. We once went through the same thing. Not to worry. Keep an open mind and one day soon you will have our beliefs."

I've known people who were "recommended" to AA by a judge, but when they chose to challenge it, were not forced. You can't be forced, but they do try to subtly slip it in. Also, most of the AA people I've met refuse to sign any kind of paper "proving" that someone attended a meeting, it refutes the whole concept of the "anonymous" in AA and they feel it's an intrusion on privacy.

 

[kirstenholme]

I've known people who were "recommended" to AA by a judge, but when they chose to challenge it, were not forced. You can't be forced, but they do try to subtly slip it in. Also, most of the AA people I've met refuse to sign any kind of paper "proving" that someone attended a meeting, it refutes the whole concept of the "anonymous" in AA and they feel it's an intrusion on privacy.

AA also insists on attraction rather than promotion. Signing papers is seen as playing a role in forcing someone to attend, which goes against its traditions. Another tradition works around every group's autonomy. Playing a role in supporting court decisions takes away that autonomy.

 

[iangoeswest]

I've known people who were "recommended" to AA by a judge, but when they chose to challenge it, were not forced. You can't be forced, but they do try to subtly slip it in. Also, most of the AA people I've met refuse to sign any kind of paper "proving" that someone attended a meeting, it refutes the whole concept of the "anonymous" in AA and they feel it's an intrusion on privacy.

You can be forced for intents and purposes, I.e., "well, you're charged with a DUI. I can set your bail at $30,000, or I can release you on your own recognizance if you go to 3 meetings a week- and bring a log, initialed by the group leader, attesting to the fact." Or, "we'll, you've been convicted of that same DUI. I can give you six months in the county jail, or I can give you probation with regular aa meetings / drug testing / alcohol monitoring." I've known literally hundreds of people offered such "choices." And I've represented one or two who were all too happy to tell the judge to go scratch,and that they'd take their 6 months and live as they pleased. The poor man's rehab! The two who come to mind both drank themselves to death, or course, as is not unexpected of one who'd choose jail over enforced sobriety. (A false dichotomy, as there is alcohol in jail - google "pruno" for the gory details. In the best of circumstances it is made in a plastic bag. In more desparate conditions it is made in a toilet, cleaned as circumstances allow and reserved of course for that exclusive purpose, the cell-members using adjacent cells for ordinary toilet business. It takes a village...but I digress.)

I can't speak to any larger picture, but local practice - and here I mean throughout the state of California - is for the group leader or some designee to be expected to initial some sort of informal "log" kept by an attendee who requests it. I have in fact created many such logs for clients' use,and have never had a complaint that there was no one at the meeting to initial it. There is of course no mechanism for verification; some non-zero percentage of those logs are surely being initialed by chuckling bartenders, no doubt...

 

[jakesteele]

=lionking;2406844]I couldn't get into AA because of the "higher authority" stuff, but gave up an excessive drinking habit (I still have problems admitting to the "A" word) three months ago. The chemical dependancy cannot be underestimated in my opinion. I found this harder than the social aspects (we have a drinking culture in Australia) or the general craving.

I wish you nothing but the best and hope it works for you, but I am rather dubious about that because of own past experience and the experience of many others around me.

The "Higher Authority" is really very simple. You don't have to have a deity god or anything remotely transcendent, metaphysical or otherwise. I turn G.O.D into an acronym which stands for Group Of Drunks because collectively they are doing something united and together towards a specific goal that you, yourself, haven't been able to achieve. Think of it as a type of entrainment where a lesser force is being pulled to and along with a greater force of a similar nature. Or, the sum is greater than the whole of the parts, or a brain trust like the people who write the Simpsons. No one person could write the whole episode and make it as funny as the group effort.

At the expense of sounding I'm on Oprah, it's still a daily struggle and I avoid parties and pubs, but what gets me by is that I keep telling myself that alcohol has been more of an enemy than a friend. Corny, I know.

One of the most important things you can do is to avoid what AA calls, "People, Places and Things". Ironically, those 3Ps have a dark gravity, so to speak, that will pull you towards and down with it.

I hope to get back to so-called controlled drinking, so that I can enjoy the social and relaxing benefits of alcohol, without drinking to excess, but will go without for the time being. Confession over.

I suggest you try an experiment. Go buy a bottle of your favorite booze and put it up in a cabinet for 30 days and simultaneously attend one AA meeting a day. The logic being that if you can leave the booze for 30 days WITHOUT thinking about it, fantasizing about it, being obsessed or being preoccupied about it, chances are that you don't have a problem.

The logic behind going to 30 AA meetings is that if you are obsessing about the booze in the cabinet you will probably start getting angry and pissy about "having" to go to those boring, irritating, cult like, and cliquish meetings and use that as an excuse to stop going for the rest of the 30 days. That would not bode well for you. If that happens, ask yourself why are you getting so mad about sitting in a room for 1 hr. a day for 30 days. If you've gone to college or other voluntary learning process, then you know that the goal far outweighs the boredom and hassle.

 

[kirstenholme]

I suggest you try an experiment. Go buy a bottle of your favorite booze and put it up in a cabinet for 30 days and simultaneously attend one AA meeting a day. The logic being that if you can leave the booze for 30 days WITHOUT thinking about it, fantasizing about it, being obsessed or being preoccupied about it, chances are that you don't have a problem.

I know quite a few alcoholics who keep alcohol in their homes for visitors and don't obsess about it. Hardly a diagnostic test.

 

[zooterkin]

There's NA, Nar-Anon, and NarcAnon, three different organization. NA (if, by NA, one means Narcotics Anonymous) is Twelve Step for addicts; Nar-Anon is Twleve Step for the families and friends of addicts; NarcAnon is a front for the Church of Scientology.

The Co$ programme is Narconon. I don't think there is anything called NarcAnon.

 

[luchog]

You can be forced for intents and purposes, I.e., "well, you're charged with a DUI. I can set your bail at $30,000, or I can release you on your own recognizance if you go to 3 meetings a week- and bring a log, initialed by the group leader, attesting to the fact."

Here in the Evergreen State, you can, in fact, be sentenced to 12-Step groups with AA the most common. I know one guy who was sentenced by a judge to attend a minimum of seven meetings a week, "so you'll be too busy to get into any more trouble". On top of a jail sentence. And if he doesn't have a verifiable log showing he attended that many, he ends up doing more jail time.

 

[TheGoldcountry]

You can be forced for intents and purposes, I.e., "well, you're charged with a DUI. I can set your bail at $30,000, or I can release you on your own recognizance if you go to 3 meetings a week- and bring a log, initialed by the group leader, attesting to the fact." Or, "we'll, you've been convicted of that same DUI. I can give you six months in the county jail, or I can give you probation with regular aa meetings / drug testing / alcohol monitoring." I've known literally hundreds of people offered such "choices." And I've represented one or two who were all too happy to tell the judge to go scratch,and that they'd take their 6 months and live as they pleased. The poor man's rehab! The two who come to mind both drank themselves to death, or course, as is not unexpected of one who'd choose jail over enforced sobriety. (A false dichotomy, as there is alcohol in jail - google "pruno" for the gory details. In the best of circumstances it is made in a plastic bag. In more desparate conditions it is made in a toilet, cleaned as circumstances allow and reserved of course for that exclusive purpose, the cell-members using adjacent cells for ordinary toilet business. It takes a village...but I digress.)

I can't speak to any larger picture, but local practice - and here I mean throughout the state of California - is for the group leader or some designee to be expected to initial some sort of informal "log" kept by an attendee who requests it. I have in fact created many such logs for clients' use,and have never had a complaint that there was no one at the meeting to initial it. There is of course no mechanism for verification; some non-zero percentage of those logs are surely being initialed by chuckling bartenders, no doubt...

I hope you don't think that I was trying to glorify alcohol abuse. I just think that AA and the legal system should be separate. and, sorry, but most of the members I've met in AA wouldn't sign any papers. I grant you the fact that you have more experience, but it's not universal.

 

[TheGoldcountry]

Here in the Evergreen State, you can, in fact, be sentenced to 12-Step groups with AA the most common. I know one guy who was sentenced by a judge to attend a minimum of seven meetings a week, "so you'll be too busy to get into any more trouble". On top of a jail sentence. And if he doesn't have a verifiable log showing he attended that many, he ends up doing more jail time.

I don't think that kind of practice would hold up to judicial review. But if it's not challenged, it just goes on. Also, as I said before, the "verifiable log" often depends on others who believe in privacy. I've attended AA meetings that only had 4 people, if neither the group leader or anyone else wishes to sign a legal document, what do you do?

 

[TheGoldcountry]

You can be forced for intents and purposes, I.e., "well, you're charged with a DUI. I can set your bail at $30,000, or I can release you on your own recognizance if you go to 3 meetings a week- and bring a log, initialed by the group leader, attesting to the fact."

OK I reread this. Yes people can voluntarily submit to terms of release. I just don't think that it should be forced, or that AA should become legally institutionalized in anyway.

 

[luchog]

I don't think that kind of practice would hold up to judicial review. But if it's not challenged, it just goes on. Also, as I said before, the "verifiable log" often depends on others who believe in privacy. I've attended AA meetings that only had 4 people, if neither the group leader or anyone else wishes to sign a legal document, what do you do?

There typically isn't a problem getting a "meeting chairman" to sign logs, as the AA requirement for anyone convicted of any offense in which alcohol is even tangentially involved is pretty widespread here.

 

[BStrong]

AVRT stands for "addictive voice recognition therapy" and is espoused by Rational Recovery - like the AA insofar as it's for alcoholics, but seemingly diametrically opposed to the methods to be used....

here they provide a brief summary of AVRT (it just sounds a bit like cognitive behavioural therapy to me....)

http://www.rational.org/html_public_area/course_avrt.html


the RR is rather critical of the AA



and rather bombastic in its tone....

http://www.rational.org/faq.html

so.....is there any consensus on addiction counselling? What method is most effective?

personally, after reading the RRs FAQ, i'd be tempted to take my chances with a supreme being

After watching the love of my life commit suicide by the bottle for the last three years, I have an opinion.

Recovery, whether it comes in the way of intervention/in patient rehab or the steps or any other alternative method, fully depends on the full commitment of the addict/alcoholic to their sobriety.

You can (I did) pay for multiple trips through the best rehab facilities available and it won't solve anything if the addict/alcoholic chooses to continue to use and/or drink once they are out of the program.

The flip side of this is that there are individuals who can and will find sobriety with a minimum of outside influence because their internal structure somehow grants them self support in overcoming their addiction issues.

Most people fall somewhere in between those two extremes.

I've spoken with folks who have real issues with any mention of a higher power and are pretty much constitutionally opposed to AA and similar step programs because of their reliance on the "HP" in the program for success. They have to find alternatives that make sense to them and AVRT seems to fit into that plan.

Which programs are most effective? since it all depends on the individual and their commitment to sobriety, I don't know how to quantify the benefit well enough to have a valid opinion on that issue, but having seen success and lived with failure, I'd take a guess that any support from any source is better than no support.

 

[BStrong]

I don't think that kind of practice would hold up to judicial review. But if it's not challenged, it just goes on. Also, as I said before, the "verifiable log" often depends on others who believe in privacy. I've attended AA meetings that only had 4 people, if neither the group leader or anyone else wishes to sign a legal document, what do you do?

Happens all the time in California, both in custody meetings at county or state facilities, and one of the successful local programs (Project 90)

http://www.projectninety.org/

Is often part of post-custody sentencing for drug/alcohol abusers.

As far as not signing an attendance sheet, I've never seen anyone refuse, and many post-custody parole and/or probation conditions require the individual in question to provide proof of attendance.

 

[zooterkin]

Here in the Evergreen State, you can, in fact, be sentenced to 12-Step groups with AA the most common. I know one guy who was sentenced by a judge to attend a minimum of seven meetings a week, "so you'll be too busy to get into any more trouble". On top of a jail sentence. And if he doesn't have a verifiable log showing he attended that many, he ends up doing more jail time.

I'm curious about the practicalities of providing a verifiable log without breaching anonymity .