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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Alara2 on May 8, 2004, at 13:34:44
This is just a vent but....
I really
> believe
> that the orthodox treatment for alcoholism (12-step
> approach) fails to acknowledge the deeper disease
> process that causes a lot of us to drink. Sure,
> there
> is a certain group of people for who just possess a
> group of personality traits that predispose them to
> addictions. But for a lot of us, I think the
> psychological and biomedical realities of depression
> and PTSD run far deeper than that.
>
> AA saves a lot of lives and provides exactly the
> kind
> of help that many drinkers need. But I can't help
> but
> feel that there is someting missing in the 12S
> approach: There is an attitude that all of our
> problems - our depression, anxiety, you name it - is
> CAUSED by alcoholism, if not by the fact that we are
> alcoholics then by the fact that we have somehow
> been
> born with `alcoholic personalities'.
>
> What really came first? The chicken or the egg?
>
> When a person afflicted by depression and PTSD tries
> to tell an AA advocate that these problems are
> fuelling her drinking, she is told: " An alkie will
> find any excuse to have a drink." That may be true,
> but it does nothing to address the fact that there
> is
> often a real, valid `excuse' that might be driving a
> person to drink. Ultimitely the drinker feels
> ashamed
> of herself for being inherently weak, for having
> having `defects of character'.
>
> GPs and even psychiatrists seem to buy into the
> "mental illness is always secondary to alcoholism"
> model. Exceptions surely exist but I've never met
> this
> kind of practitioner. The problem with this as that
> most people with depression/anxiety/PTSD who present
> with addiction problems are usually fed the "detox
> and
> then go to AA line". Simple. Take an antidepressant
> and go to meetings. After all, the DRINKING must be
> the underlying culprit. Once the person abstains for
> a
> while, she'll be psychologically well.
>
> In Australia, work-place absenteeism resulting from
> alcohol abuse costs the tax payer a lot of money.
> Alcoholism is also one of the leading causes of
> chronic illness and death. That's why I'm at a loss
> to
> understand why our government fails to put money
> into
> researching the real etiology. Surely we're past
> these
> days of `one size fits all.'
>
> I can only assume that it all comes back to the
> myths
> perpetuated by our culture: If you are alcoholic it
> MUST be your own fault. Why waste valuable funds
> help
> self-destructive people get better when there are
> people dying needlessly of cancer? Why waste money
> training GPs to look more holistically at addictions
> when these alcoholics and drug addicts have only
> themselves to blame?
>
> One day the person struggling with chronic anxiety
> or
> depression will be able to walk into a doctor's
> office and say: "I've been struggling in life and am
> worried about my drinking". Instead of fearing
> judgement, that patient will know that the
> practitioner views her illness like any other and
> that
> he/she will be equipped to investigate the REAL
> causes
> of her disease.
>
> But meanwhile? What can we do?
>
Just curious about others' opinions...Thanks,
Alara
Posted by beatrix34 on May 8, 2004, at 21:43:11
In reply to Why AA doesn't always work..underlying pathology, posted by Alara2 on May 8, 2004, at 13:34:44
I agreeabout AA, I went to AA for my drinking initially but hated it. I have a lot of issue with that particular 12 step program...but I have to say, not ALL 12s groups are the same.
In my personal experience, I have been in a treatment centre (5 weeks), that centre also included trauma and eating disorder programs, as well as various other programs. I then started to go to 12s meetings. At first I wen to AA...and as I said, hated it..,I then went to Narcotics Anonymous and found that I liked their way of thinking uch better. They believe that addiction is a disease and that drinking or doing drugs is only a symptom of your disease. The heart of that disease lies in your past experiences, your secrets, your mental health, and a gammet of other possiblities. They believe that although everyone ended up in the same place, we all took our own path in getting there. That your using is not the problem...but the result.
I have been clean in the rooms of NA for just over 5 years now and...although 12s is not for everyone, you have to remember some people are sicker than others in those rooms...but they do provide the support that many people need to START to even get to the root of their problem.
Not all 12s groups are AA...and not all have the exact same set of beliefs...nor does any one person in any of those rooms possess the same beliefs...nor will any of them take the same path to recovery.,,the steps are but a guide for people to help them discover where their core issues lie, and to hopefully start them on the path of healing...
Hope that this givesyou even a bit of a different perspective to look at. :)
Bea
Posted by Fred23 on May 8, 2004, at 23:03:25
In reply to Why AA doesn't always work..underlying pathology, posted by Alara2 on May 8, 2004, at 13:34:44
(Apologies if this appears twice -- my post didn't seem to take.)
The origin of AA was in an era long before our more modern medical understanding, so they treat the cause as a "black box."
Unfortunately, the agents people use to quiet their overactive brains, e.g. alcohol, are not very effective, and cause their own problems, which are more visible.
Elsewhere on this forum I've seen discussions about this, and how some of the newer AA members are more understanding of this than the older members.
Also, that AA doesn't represent itself as the entire treatment.
Posted by arrie on May 9, 2004, at 22:46:14
In reply to Why AA doesn't always work..underlying pathology, posted by Alara2 on May 8, 2004, at 13:34:44
I would never go to a 12 step from what i have heard. I know my problem is a self induced one not a disease. Funny I never had this disease before I started taking pain killers, did they both just happen to occur at the same time in my life. Anyone with half a brain can separate the two processes. The reason the programs have any success is a good majority of the people are so desperate any way of labeling and idenifying their problem is most likely a comfort. But you are right, even after you are "cured" or clean as they say, I dont care for that phrase either, you will have all the same issues. I think for what its worth if you know whats bothering you, work on that and see if the chemical dependancy issues subside any. Problem is once you do figure it all out, you still have to deal with the fact that your body not your mind has a dependancy at this point, and to me that is the only legitimate disease going on. Good luck
Posted by beatrix34 on May 11, 2004, at 1:01:42
In reply to Re: Why AA doesn't always work..underlying pathology, posted by arrie on May 9, 2004, at 22:46:14
Arrie - If your body is chemically dependant...do you honestly think that will just "subside" with a little councelling? I don't think so...also "clean" and "cured" are two TOTALLY seperate things...your body can be "clean" of your drug of choice...but you are NEVER cured...just as therapy is an ongoing process...such is recovering from addiction...in my opinion...having been down that road personally...your body needs to be "clean" to even begin dealing with the issues at hand...how you do that is up to the individual...12s programs are not a place to "label" your disease...but a place to get support to start to deal with your issues...
Posted by Tony P on May 11, 2004, at 13:37:53
In reply to Re: Why AA doesn't always work..underlying pathology, posted by beatrix34 on May 11, 2004, at 1:01:42
Most AA groups I go to (and the big book) talk about alcoholism as a disease. Most treatment programs (and I believe the Diagnostic Manuals) also accept it as a disease just as clearly defined as cancer or diabetes.
This is born out by genetic studies - people with one alcoholic or addict parent have at least a one-in-seven chance of developing alcoholism, other drug addiction, or a related compulsive disease such as bulimia. With two addict parents, the odds go up to four-in-seven (almost 60%!), and that leaves out those parents and children who for one reason or another carry the genes but don't develop the disease.
Like many other diseases where there's a genetic predisposition, you _may_ not become an alcoholic even if you carry the genes (e.g. if you decide never to drink for some other reason), but there is really no doubt that alcoholism/addictive disorder is a disease. The thing is, that as it progresses it develops a whole set of typical destructive behaviours, "character defects", and psychopathology. After abstinence, these continue and then must be dealt with.
AA's recognize this, so (especially in groups with a lot of long-term sobriety), the discussion tends to focus on these life issues (admittedly, the language is antiquated and strongly oriented toward the original Oxford Group's spirtual/self-improvement approach).
AA is not for everybody, and the literature says so, although a few AA'ers disagree vocally - their privilege.Like another poster, I'm finding NA much more helpful these days. With possible exceptions, the typical NA group is a far cry from the early ones 40 years ago - every possible variety of addiction is represented, it is not just a group of bikers and street people (it never was, really), and I feel truly at home there despite my main adddictions being "just" to legal OTC pharmacy drugs and alcohol. In the groups I'm familiar with, the overall attitude in sharing is more personal and less rigid than _some_ AA groups, and people talk about everything from rock-bottom addiction issues to how they're tearing their hair out over their PhD thesis. Every group is different (literally autonomous), so don't judge either fellowship by just one or two groups.
Tony
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