Addiction Treatment
and Religious Freedom
a pamphlet by Cliff Walker -- April, 1993
Please Note: This pamphlet is outdated. Rational Recovery has gone through several changes since this article was written. Because I want to present this article as it appeared in a predecessor to Critical Thinker (itself a predecessor to Positive Atheism) I must note two very important corrections: 1. RR is no longer atheistic, but teaches that one's religious beliefs are irrelevant to quitting an addiction. The founders realized that by teaching "no-higher-powered sobriety," RR was making the same mistake it was accusing Alcoholics Anonymous of making: having an opinion on an irrelevant subject. Many religious people likewise dislike AA's theology. Complaints range from those who consider the notion of inventing one's own understanding of God to be idolatrous to those whohave serious problems with the notion of a rescuing deity.. 2. RR no longer teaches Rational-Emotive-Behavioral Therapy (RTBT, formerly called RET) as useful for quitting an addiction. RR now prefers the direct approach of its own Addictive Voice Recognition Technique (AVRT) and advocates planned, permanent abstinence. Albert Ellis, who invented REBT, agrees that AVRT is probably more effective than REBT and that REBT may be useful to some once they have quit.
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Addiction Treatment
and Religious Freedom
by Cliff Walker -- April, 1993
Every Thursday night, the Center for Rational Thought(1) opens its doors to the latest unsung casualties of legally mandated religion in America: substance abusers. For decades now, our courts and agencies have sentenced drug addicts into treatment and have forced people to attend Twelve Step meetings. While most agree that treatment and meetings might do some people some good, many authorities are unacquainted with the blatantly religious curriculum of Twelve Step programs. Fortunately, more and more policy makers are discovering what these organizations teach. In four cases, federal courts decided that Alcoholics Anonymous (AA) fits the legal description of a religion. Government agencies in those states cannot lawfully compel people to practice this religion; they must offer a reasonable alternative.
An entire branch of medicine has given itself over to the spiritual teachings embodied in the Twelve Steps. This popular addiction treatment method advocates a life-long regimen of repentance, faith, prayer, and surrender to the will of a personal, transcendent deity (known variously as "Higher Power," "God," and "Him"). The other steps require a moral inventory, confession, an unrealistic reliance on the supernatural, forgiving others, contrition, making amends, self-appraisal and self-rating, daily devotions to God, and uncompensated proselytizing efforts to bring other subjects into the fold. Members tell one another, "We can only keep what we have by giving it away"(2) as they "carry this message"(3) into jails and institutions.
Please keep in mind that countless substance abusers who are under the thumb of the authorities must attend Twelve Step meetings in order to, for example, stay out of prison, keep their children, or hang on to a job or a disability check. The Twelve Step programs make it clear that there is no such thing as completing the program. Members are urged to "keep coming back" for life if they want to keep a drug or alcohol problem in check.
In this age of frothing anti-drug hysteria, drug- and alcohol-dependent people often cannot determine their own treatment options -- as if the plural options even applies here. For the past decade or so, America's addiction treatment industry has, for the most part, become monopolized by the Twelve Step approach. Addicts who want help have had very few choices; one popular slogan sums it up: "Work the steps or die...!"
AA and its offshoot organization NA (Narcotics Anonymous) publish membership
surveys. Both organizations admit that fewer than half their members at
any time have been clean and sober for longer than a year. Those are not
very good odds. People who get clean on their own, who outgrow their problems,
comprise, by far, the largest group of former substance abusers.
How Did AA Become So Powerful?
Alcoholics Anonymous was developed by a stock broker and a proctologist in the mid-thirties; we can trace its roots to the temperance movement of the nineteenth century. Unlike that movement, which saw all drinking as sinful, AA recognized several types of drinkers: normal drinkers, problem drinkers, and those they called "alcoholics." Originally, AA was only for the very worst cases and only as a last resort. Back then, a problem drinker was not necessarily a true "alcoholic."
The alcoholic, they postulated, has a disease, an allergy to alcohol, which cannot be cured but can be arrested through supernatural intervention. One would think a medical problem warrants medical treatment -- not religious conversion. The disease concept caught on like wildfire; with it, the addict can relinquish all responsibility for his or her situation. "We suffer from a disease, not a moral dilemma."(4) No one ever pretended to be absolved from repairing past damages, however, and some Twelve Step literature goes into great detail about the moral shortcomings and so-called character defects of the typical "recovering" addict.
The AA recovery program is quite simple. Elements of the Christian conversion experience are employed to induce what AA calls "vital spiritual experiences" or "huge emotional displacements," an idea derived from the experiments of Carl Jung on an early AA member.(5) A prospect is confronted with the possibility that he or she is beyond hope, or "powerless." This breaks down the subject's inner defenses so that new inner strength can come forth.(6) At this point, AA stops being realistic.
Though it may seem drastic, this technique works in many severe cases. Thousands of AA and NA members are clean and sober today. More often than not, however, this plan backfires; many addicts readily accept the part about being hopeless but reject the likelihood of magical help from above. Here is where the Twelve Steps can do more harm than good: people walk out more convinced than ever that they will never change.
The cornerstone of AA is the idea that no "alcoholic" can quit through sheer willpower; those who do not accept this idea will not get anywhere in AA. In some circles, the concept of powerlessness over drugs and alcohol is taken to its logical conclusion: complete personal powerlessness in every area of life. Many therapists teach that nearly everyone has "the disease of codependency" -- and needs to be in therapy, of course!(7)
The founders thought AA might be more palatable if they got rid of Yahweh the volcano god and told followers to choose their own higher power. The catch is that it must be a personal, rescuing deity: a living god who can hear prayers, has the compassion to respond, and is powerful enough to do the job. No other model works here. The phrase, "God as we understood Him"(8) means just that -- they understand God to be a Him.
While most AA members are okay with the "God" part, Twelve Step
apologists go on and on about your right to substitute the group, nature,
a light bulb (no kidding!), or a tree in attempts to make the program appear
non-religious. However, the Twelve Steps become absurd when interpreted
this way: "We humbly asked a light bulb to remove our shortcomings."
Yeah, right! Some consider this an unethical bait-and-switch
tactic. A few think AA and NA would be more effective if they went ahead
and became religions. RR offers a different solution: free-market
competition.
A Rational Alternative
Jack Trimpey founded Rational Recovery in an effort to go to bat for those who strike out in AA. Trimpey attended AA meetings and, in spite of the religious trappings, quit drinking on his own. He took advantage of professional training he had received from the Institute for Rational-Emotive Therapy. Later, as a clinical social worker during the 1980s, he referred many alcoholics to local treatment centers. He saw that some people aren't good candidates for the AA approach.
Trimpey does not seek to replace AA, only to compete. "Unless you have a specific objection to AA," he says, "it can be of immense help to you and your family. But alas, many of us do have specific objections to AA, and for us an alternative, a rational alternative, is desperately needed."(9)
Rational Recovery incorporates the Rational-Emotive Therapy developed by Albert Ellis, Ph.D., in the 1950s. Firmly rooted in atheism (Ellis has been published by American Atheist Press(10) and RR was once affiliated with the American Humanist Association), the Rational Recovery program is a direct counterpoint to the Twelve Step philosophy. AA is faith-based, for people who believe; RR is reason-based, for people who think. While everyone does a little of both, most of us lean toward one philosophical system or the other.
People often come to an RR meeting and do little more than realize that AA does not have a monopoly on the truth: that someone need not have experienced the "mystery" of recovery in order to show you how to quit; that quitting drugs is, for the most part, not that hard; that you can get and stay clean and sober on your own -- without any outside help; and that moral betterment is not relevant to recovery from addiction. (These are facts that many treatment centers would rather the public not know.)
Just knowing that RR exists and sees things differently is enough for many people; they walk out with a clearer understanding of their situation and solve their problems themselves. Statistics show that such people have the best odds of making it.(11) For those who do need help (or who merely think they need help), Rational Recovery is one of several methods to enable people to "kick the habit" and get on with life.
An important point in Rational-Emotive Therapy is the idea that what you believe determines how you feel. In this sense, the words we use can affect how we see ourselves. The folk expression alcoholic, for instance, is profoundly stigmatized and cloaked in mystery -- but it doesn't really mean anything. Doctors use the terms alcohol abuse and alcohol dependence to describe levels of persistent drinking. RR prefers the term alcohol dependence because "it actually describes the problem, i.e., 'I am dependent on alcohol,' and even suggests what you may do about it, i.e., 'I had better become independent from alcohol.'"(12)
One tool we find useful in recovery is Addictive Voice Recognition Technique (AVRT). The main idea in AVRT (pronounced "avert") is to think about one's own thinking processes. Everyone has an inner "thinking voice" and, in our "mind's ear," we can hear ourselves talking to ourselves. AVRT demonstrates that (in the case of drug or alcohol abuse, anyhow) thought always precedes action; it is impossible to use drugs or to drink apart from a deliberate decision to do so. We may not be able to stop the urges and ideas but we can and do control our response to those ideas. The goal, in this case, is to "think about those thoughts, evaluate them, weigh them, and then decide whether or not to go along with them.... Drinking is always a choice."(13)
The situation facing a drug addict trying to clean up in the world of today's addiction treatment industry is summarized in the following passage from The Small Book:(14)
During the years of alcohol or drug dependence very little emotional growth is possible, because personal growth is usually the outcome of mastering fears, discomforts, and anxieties. The use of drugs and alcohol to cope with negative emotions, including "boredom," prevents you from learning independent ways of feeling good.... With the removal of alcohol you are forced into a strange new world, one devoid of the fulfillments, however austere, associated with alcohol use. Many current approaches accept the inevitability of continued emotional dependency; you are expected to replace dependency on alcohol with dependency on something more benign. In RR, you are given the means to reject dependence as a matter of principle and to form a personal philosophy that is by definition conducive to a durable, fulfilling sobriety in which you will independently pursue your own goals.
Rational Recovery is the main force behind the move to bring choice to addiction care. But the idea makes so much sense to so many people that no one can keep up with the changes taking place. More and more treatment centers are rejecting the Twelve Steps altogether. Many booksellers report that sales from the Twelve Step recovery section have dropped significantly over the past year. Meanwhile, copies of The Small Book are, according to one Portland bookseller, "flying off the shelf"; the publisher cannot keep up with orders.
It would be impossible to rid the addiction treatment industry of AA's
influence. After all, the disease model provides the industry with its
only reason to exist: treating the "disease" of alcoholism. If
we are going to force people into treatment, we cannot allow religion to
be the only choice.