Category Archives: Books

New book hits hard at fundamentals of 12-step based sobriety support

In a book that’s getting plenty of discussion around the Internet, including multiple reviews, “The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry,” is one of the hardest-hitting and most direct critiques yet of the 12-step ideas, structure and model for sobriety support. Per the subtitle, it’s about more than just Alcoholics Anonymous and Narcotics Anonymous. Authors Lance Dodes and Zachary Dodes, the former with  35 years of psychiatric experience, tackle how the 12-step model has become accepted by the rehab industry, and also the courts, including noting, of additional importance to LifeRing, legal rulings that 12-step programs are a religion in terms of First Amendment views. and therefore mandatory  orders to AA or NA meetings are not allowed.

From the review on Amazon:

In The Sober Truth, acclaimed addiction specialist Dr. Lance Dodes exposes the deeply flawed science that the 12-step industry has used to support its programs. Dr. Dodes analyzes dozens of studies to reveal a startling pattern of errors, misjudgments, and biases. He also pores over the research to highlight the best peer-reviewed studies available and discovers that they reach a grim consensus on the program’s overall success.

But The Sober Truth is more than a book about addiction. It is also a book about science and how and why AA and rehab became so popular, despite the discouraging data. Dr. Dodes explores the entire story of AA’s rise, from its origins in early fundamentalist religious and mystical beliefs to its present-day place of privilege in politics and media.

The Sober Truth includes true stories from Dr. Dodes’s thirty-five years of clinical practice, as well as firsthand accounts submitted by addicts through an open invitation on the Psychology Today website. These stories vividly reveal the experience of walking the steps and attending some of the nation’s most famous rehabilitation centers.

The Sober Truth builds a powerful response to the monopoly of the 12-step program and explodes the myth that these programs offer an acceptable or universal solution to the deeply personal problem of addiction. This book offers new and actionable information for addicts, their families, and medical providers, and lays out better ways to understand addiction for those seeking a more effective and compassionate approach to this treatable problem.

To many LifeRingers who came to LifeRing from 12-step programs, these critiques may already be known. But, as Dr. Dodes notes, they’re still not well known in either the court system or his own profession.

Some, based on the first major media review of the book, in Salon, an excerpt from the book by the authors, may fear this book engages in “AA bashing.” However, Dodes does note that the 12-step methodology does work for some people. Rather, to me, the book seems to be what flows from his observations of “medical best practice” based on his 35 years as a psychiatrist.

In one earlier book, per a review on Amazon, he labels as “myth”:

  • Addictions are fundamentally a physical problem.
  • People with addictions are different from other people.
  • You have to hit bottom before you can get well.
  • You are wasting your time if you ask “why” you have an addiction.

In other words, he seems to discuss issues of addiction from a variety of medically and psychologically informed angles. In that book, these issues seem to be related to what he presents in his current book, namely that addiction is a psychological issue as much as anything, and that while addictive substances affect brain chemicals, that’s not the most productive way, or the right level of approach, to address this situation. I do know that neuroscientist Carl Hart, in his new book, “High Price,” is more explicit about ideas about how addiction boils down to dopamine problems are more and more panning out as not true. (I’ll have a review of that book in a couple of days.)

Per the informational angle, this book is gaining “traction” nationally, and aside from any possible concerns about “tone” on Dodes’ discussion of 12-step methodology, raises important issues from a medical stance. Besides Salon, it’s now also been reviewed in The Atlantic and at NPR, as part of an author interview.

There is one thing that is a bit eyebrow-raising, that I noticed most at his NPR interview. He talks about “managing” addiction. I don’t know if “moderation” is under his “management” ideas or not.

You can learn more about Dodes, including a blog he maintains on addiction issues, at his website.

Note: This post h as been lightly edited since its original posting to drop most references to other Liferingers’ opinions and to add a reference to another new book about addiction, that of Hart.

The psychology of quitting, and quitting drinking

Getting sober means quitting, quitting drinking. In the “can-do” and “rugged individualism” that seems part and parcel of American society, the idea of “quitting” often has other attendant psychological issues. Like, if you quit something, that means you were a failure. You didn’t do something successfully.

And, that can be seen as applying to the need for sobriety, too. A person “failed” at being a successful drinker. We even have semi-jokey stereotyped statements about people “not being able to handle their liquor” and similar.

The book, “Mastering the Art of Quitting” has nothing specific to sobriety. But, as a self-help book that isn’t overly laden with blind-rosy optimism, and that talks about goal strategies and similar ideas, a person embarking on the journey of sobriety can surely mine nuggets from this issue, not only about sobriety itself, but, for many people, earlier life issues that may have contributed to eventual addictive alcohol drinking or drug use.

The good points of this book are that it says we shouldn’t be afraid to quit something. Nor should we see shame or a sense of failure in doing so.

Personality factors that affect this, strategies for planning quitting, etc., all get discussed.

AA vs moderation — false dilemma rears its head again

NY Times image

And unfortunately, it rears its ugly head in a New York Times op-ed, and even worse, it’s one of those New York Times op-eds written by an author who’s got a new book to plug.

Gabrielle Glaser thinks that she is saving many a woman with some degree of a drinking problem from the moralizing of AA. She gets right that, as well as noting that AA is male-focused, unscientific, and still largely rooted in the days of its founding.

She also gets right this:

Women increasingly need help, as their drinking has escalated. Women are being stopped more for drunken driving than they were two decades ago. They’re also the biggest consumers of wine, buying the larger share of the 856 million gallons sold in the United States in 2012. These women are drinking partly because alcohol is a socially respectable way to slog through the smartphone-tethered universe of managing demanding careers, aging parents, kids’ activities and relationships at once. And while it’s not healthy to pour yourself a third or fourth glass every night, it doesn’t mean you’re powerless to do anything about it.

But, she then says the alternative to this:

(T)he A.A. program offers a single path to recovery: abstinence, surrendering one’s ego and accepting one’s “powerlessness” over alcohol.

Can, and should, (often) be moderated drinking.

I put the “often” in parentheses because she does, at her website, albeit on a hyperlink whose linkage is broken, or was for me, abstinence-only alternatives to AA. Besides us, and the others, I was simply flabbergasted that, because her column was about drinking problems particular to women, she wouldn’t even mention Women for Sobriety in the column.

She then goes on to specifically tout Moderation Management, without noting, besides just founder Audrey Kishline, its own problematic history, lack of verifiable information, etc. This is a sad case of wanting to have one’s cake and eat it, too.

Next is this:

This approach isn’t for severely dependent drinkers, for whom abstinence might be best.

“Might”? Try “is.” Period.

Unfortunately, she got curt with me when I pointed out some of the above issues in an email. I have made multiple comments on the Times op-ed, my original ones being about the book itself, then responding to a couple of diehard AAers trotting out the classical “no true Scotsman” stance in saying Glaser wasn’t critiquing true AA, etc.

Her book is getting a number of unfavorable ratings on Amazon from people who are NOT diehard AAers, for a variety of reasons, so a few people are looking at the devils in the details.

‘We look at red wine like it’s dark chocolate’ — New Book Examines Women and Alcohol

drinkAnne Dowsett Johnston is the author of a new book entitled Drink that explores the relationship between women and alcohol. In a recent interview, Johnston said, “‘We look at red wine like it’s dark chocolate, … We know the downsides of the tanning bed and trans fats, but not the downside of our favorite drug.’

Johnston, 60, herself in recovery, is experienced in both journalism and academics and brings both those skills to bear on her contention that women are increasingly being drawn into addiction.

Unlike men, Johnston claims, who tend to drink most in social settings, women more often ‘uncork the bottle at home,’ says Ms Johnston, in order to self-medicate their anxiety and depression.

Read more by clicking Here.

 

 

You Are Not Your Habits!! New Book Shows How to Break Free of Them

habitI recently read a book called The Power of Habit:  Why We Do What We Do in Life and Business,” by Charles Duhigg.  I think that many folks in early recovery, or in contemplation of recovery, will find this book enormously useful.  It uses a number of real-life vignettes to illustrate the power of habit, how habits form, and how they can be changed.  One of the most intriguing concepts in the book is that of “keystone habits,” seemingly trivial habits that – if altered somehow – create a cascade effect that renders other, more pervasive and intractable habits, amenable to change.  Another crucial concept is that actually believing that you have within your power the ability to change your habits is an absolute prerequisite to changing them.

I think that this selection from the last chapter of the book does a fine job summarizing his thesis, and I have copied it for you below:
   “Habits are not as simple as they appear.  As I’ve tried to demonstrate throughout this book, habits – even once they are rooted in our minds – aren’t destiny.  We can choose our habits, once we know how.  Everything we know about habits, from neurologists studying amnesiacs and organizational experts remaking companies, is that any of them can be changed, if you understand how they function.
   “Hundreds of habits influence our days – they guide how we get dressed in the morning, talk to our kids, and fall asleep at night; they impact what we eat for lunch, how we do business, and whether we exercise or have a beer after work.  Each of them has a different cue and offers a unique reward.  Some are simple and others are complex, drawing upon emotional triggers and offering subtle neurochemical prizes.  But every habit, no matter its complexity, is malleable.  The most addicted alcoholics can become sober.  The most dysfunctional companies can transform themselves.  A high school dropout can become a successful manager.
    “However, to modify a habit, you must decide to change it.  You must consciously accept the hard work of identifying the cues and rewards that drive the habits’ routines, and find alternatives.  You must know that you have control and be self-conscious enough to use it – and every chapter in this book is devoted to illustrating a different aspect of why that control is real.
    “[A]lmost all the . . . patterns that exist in most people’s lives – how we eat and sleep and talk to our kids, how we unthinkingly spend our time, attention, and money – those are habits we know exist.  And once you understand that habits can change, you have the freedom – and the responsibility – to remake them.  Once you understand that habits can be rebuilt, the power of habit becomes easier to grasp, and the only option left is to get to work.”
Joseph A. Mott, M.D., J.D.