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Just how irrational is AA? Reaction to Glaser's article

April 8, 2015
by Terry L. Stawar, Ed.D. LMHC, LCAC
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I've  just read Gabrielle Glaser's Atlantic article entitled, “The Irrationality of Alcoholics Anonymous,” for the third time. With a master's degree in history from Stanford, experience as a writer in upper echelon publications, Glaser,   describes herself as an award-winning journalist. She  is also the author of Strangers to the Tribe: Portraits of Interfaith MarriageThe Nose: A Profile of Sex, Beauty and Survival, and most recently Her Best-Kept Secret, Why Women Drink - And How They Can Regain Control.

Glaser attacks Alcoholics Anonymous (AA) as an ineffectual, nonscientific, outdated approach to alcohol treatment,  that has nevertheless managed to dominate the field and in the process, prevent many people from getting the help they so desperately need.  Glaser strongly advocates for the use of pharmacological approaches to  treatment and argues that abstinence-based models may actually  stand in the way of treatment for many individuals with alcohol use disorder. She seems especially enthralled with the notion that many people can learn to moderate or control their drinking--a controversial approach, but one that is not lacking in scientific evidence.

I found myself agreeing with almost everything she said, but I still didn’t feel comfortable with what I was reading. Maybe I'm paranoid, but at times Big Pharma seemed to be lurking in the background.   Maybe that's why I had to reread it.  I did love   her line that Minnessota is known as "The Land of 10,000 rehabs."

Okay already, AA is not a panacea, and it is not for everybody. Most people in the behavioral health field have known for decades that many AA groups--with their aversion to medications, confrontive methods, and reliance upon spirituality--are not appropriate for many patients. I probably wouldn’t suggest sending a person with schizophrenia, a teenager just experimenting with alcohol, or a rabid atheist to AA. Penicillin, for example, is not   ineffective or  a bad medicine just because a lot of people are allergic to it and may have a bad reaction.

In journalism, however, if you want to draw attention to yourself, the most surefire method is to pick a fight, as it is conflict that sells and attracts readership. The AA community, if there is such a thing, is certainly a worthy adversary, given the vast number of members, groups, and people who claim to have benefited from it.

Glaser seems dismissive of personal testimonials in support of the efficacy of AA, preferring instead to rely upon some idiosyncratic research about AA recovery rates and Cochrane Reports that assert an obvious lack of scientific evidence to support AA.

On the other hand, she has no problems with personal testimonies regarding how AA has  harmed individuals, prevented them from getting the help they needed, caused them to relapse, or, in her own case, how effective naltrexone was in curbing the pleasure she received from a glass of wine.

At times she seemed like the movie critic, who criticizes a movie for not being what she thought it should have been, rather than reviewing it for what it is.  AA is not an evidence-based treatment, never purported to be one, and given its basic structure, probably will never achieve that distinction.

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Terry Stawar

President/CEO (LifeSpring, Inc.)

Terry Stawar

@tstawar

planetterry.wordpress.com

Terry L. Stawar, EdD, is President and CEO of LifeSpring Health Systems, a community behavioral...