Monday, April 9, 2007

The Real AA: Behind the Myth of 12-Step Recovery

By Ken Ragge
ISBN 1884365140

Reviewed by Marty N.

This is the second edition of the authors' More Revealed: A Critical Analysis of Alcoholics Anonymous and the Twelve Steps, whose cover showed a Sherlock Holmes character tearing the sheep's mask off a blood-slavering wolf. It is Ragge's thesis that AA is a cult, that its methods are comparable to brainwashing, and that practice of AA's program "usually makes the underlying problems of alcoholics and addicts much worse."

Ragge begins his exposition with a short sketch of the Oxford Groups, a Protestant evangelical sect out of which AA evolved. He shows that a number of the insidious conversion techniques of the Oxford Groups are alive today in the AA program. After a digression of five chapters in which Ragge expounds his own theory of the addiction problem, of which more later, the author then picks up the attack again in Ch. 9, "Meetings." This describes in a generic way all the elements of an archetypical AA meeting, with the standard speeches, the standard audience responses, and the insecure feelings of the newcomer in the middle of it all. It is Ragge's view that this environment is similar to that of an "addictive family system" in which the individual's own perceptions and feelings are denied and he is made to adopt a synthetic and dysfunctional identity. Ragge finds that the prevalence of cliches in the meeting talk serves as a short circuit for critical thought and is symptomatic of mind-control cults.

The following two chapters then take the newcomer into the organization and through the 12 steps, one by one. Ragge points out that the organization presents itself at the outset as a "broad highway," where everything is only "suggested" and nothing is required. This "soft sell" lures the newcomer in. Then comes the "90 in 90" proposal, where the newcomer is encouraged to do a "trial run" of 90 meetings in 90 days to see if he likes it. The real purpose and effect of the 90/90, according to Ragge, is to separate the newcomer from his social network, isolate him, and envelop him in the AA environment to the exclusion of all else. Once AA has become the sole source of the individual's information and social support, then the newcomer is induced to get a sponsor and do the steps.

The general thrust of the steps, in Ragge's view, is to demolish the individual's sense of self and make him dependent on AA. Ragge calls the Steps "a prescription for helplessness, self-alienation and depression." Ragge points out that around steps four and five, the program takes the newcomer through a fundamental paradigm switch. Earlier, the newcomer's problem was defined as a medical disease, for which the individual is blameless. Now "medical" is morphed into "moral" and the message is that the individual drank because of "defects of character." This immediately reloads the burden of guilt and shame that the medical disease theory might have discharged, and the individual now defines himself as a thoroughly bad and worthless person. Survival beyond this point is possible only through divine grace; redemption is attainable only by bringing in others to start the process anew.

Ragge provides an unflattering portrait of some of the "model recoveries" obtained by this means, including that of AA co-founder Bill Wilson himself, who spent eleven years in morbid depression, and Kitty Dukakis, whose AA involvement led her from a trivial diet pill habit to a major dual diagnosis with an Rx for lithium. In a follow-up chapter, Ragge sketches very briefly the anonymous infiltration of AA into the medical profession, into Congress and state legislative bodies, courts, and the media. Finally, Ragge discusses the plight of the person who leaves AA, isolated, with shattered ego, profoundly depressed, and therefore likely to relapse or commit suicide; Ragge gives some suggestions for surviving this transition and returning to normalcy.

The portions of the book that expose AA are worthwhile reading. Ragge has drawn heavily on AA's own literature and on his own experience in the program, and the chapters ring with credible detail and with emotional sincerity. Obviously Ragge's experience is not that of everyone, and many will dismiss his account as a malicious caricature, but Ragge's core feeling of abuse and manipulation at the hands of the 12-Step program has so many echoes in the personal histories of other survivors that one cannot dismiss it as a mere idiosyncrasy. This is a soapbox polemic, but it is a necessary and readable antidote to the AA-idolatry that dominates the collective brainwaves.

Going into the book in more particulars reveals an uneven product. Some of his insights I have not seen before, e.g. his analysis of the fourth and fifth steps as a bait-and-switch from the medical to the moral model; this I think a valuable contribution to the analysis. Some of this subject matter, e.g. Bill W.'s belladonna trip and his depression, and the role of anonymity in penetrating secular institutions, has been described much better and more persuasively elsewhere, e.g. in William L. White's Slaying the Dragon. Some of it is, I believe, ludicrous, as when he claims that "Shit Happens" is an AA slogan. Some of it is stretched, as in the equation of the Oxford Groups and AA; Ragge admits that AA's anonymity principle represented a complete break with the OG, but he does not see how central this rule is to AA's modus operandi; it is the very engine of AA's secular infiltration. Some of Ragge's terminology I find annoying, such as use of the term "grouper" to describe AA participants; a grouper is a fish. It is also important to realize that Ragge criticizes AA's "spirituality" from a religionist rather than from a humanist viewpoint. And, as might be expected in a pamphleteering effort of this kind, Ragge leaves it a mystery why AA does in fact serve as a vehicle by which a great many drunks successfully maintain abstinence -- more than through any other organized effort at this time. Still, the main thrust of this expose of AA is keenly felt, richly documented, and worth a wider audience. Even if Ragge is only half right, his study goes a long way to explain AA's apparently abysmal retention rate and the low abstinence rate of AA participants, discussed in Ch. 2; and this would tend to shed light on AA's abhorrence at being subjected to quantitative outcome studies.

Unfortunately, this workmanlike pamphlet is undermined by the addition of six or seven embarrassingly thin and unnecessary chapters in which Ragge spins out his own theory of addiction. In a nutshell, he believes that adult addiction is a psychological disorder caused by childhood abuse. Although there is evidence showing that many addicts suffered childhood abuse, there is no evidence that all or even most abused children become addicts. Ragge's chapter attacking the medical disease theory, which long antedates AA, is a clumsy hatchet job, and his analysis of animal experiments is deplorably unsupported by any research of the past 20 years; contrast, for example the monumental work of Eliot Gardner. Ragge advises the drinker to avoid support groups and look for a psychotherapist instead, but to drop instantly any therapist who suggests a diagnosis of alcoholism! In this thin and strained denial that such a thing as alcoholism exists, Ragge reveals himself as an acolyte of Stanton Peele, the writer-for-hire of the alcohol industry, who does a gushing introduction for the book. Predictably, Ragge's pop-psych etiology leads up to the irresponsible conclusion in Ch. 15 that the drinker is probably better served by aiming for moderation than for abstinence. Audrey Kishline's work, which attempts to draw a clear line of demarcation between alcoholics and problem drinkers, is a model of clinical responsibility by comparison. Jack Trimpey, co-founder of Rational Recovery, contributes a laudatory foreword. A firm editorial hand would have greatly improved this title and enhanced the author's credibility by excising the transparently self-indulgent chapters on addiction and moderation so that Ragge's vigorous expose of AA could stand on its own merits.

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