10/13/17

Feuding Ideologies, Part 2

© Michal Bednarek | 123rf.com

In the first paragraph of “Dying To Be Free,” you are introduced to Patrick, a smiling 25 year-old who had just completed a 30-day drug treatment center. Among his possessions was “a talisman he’d been given by the treatment facility: a hardcover fourth edition of the Alcoholics Anonymous bible known as ‘The Big Book.” It pages were full of highlights and Post-It notes. He was said to be a “natural” 12-step convert. Four days later, his father found him dead of an overdose.

As you read about Patrick’s struggles with addiction, you get a picture of how he and his parents tried to help him establish sobriety. There is a reference to his residential treatment stay as a “30-day wonder,” where he received a crash course on the tenets of the 12-steps. “Staff at the center expected addicts to reach a sort of divine moment but gave them few days and few tools to get there.” In Part 1 of this article, I addressed concerns that an underlying ideology of addiction as a strictly biomedical disease contributed to a biased, distorted picture of addiction treatment in the U.S. by the author of “Dying To Be Free.” Here we will look at how he also misrepresents the recovery philosophy and history of A.A.

There is a preponderance of religious or magical rhetoric when describing 12 Step, abstinent-based change in “Dying To Be Free.” Already we’ve noted the main text of Alcoholics Anonymous, also called Alcoholics Anonymous, was referred to as a talisman and a “bible.” Patrick was a “natural 12-step convert.” Another reference described the AA Big Book as being the size of a hymnal, with an appeal to faith made in “the rat-a-tat cadence of a door-to-door salesman.” Addicts at a certain treatment center were supposed to “reach a sort of divine moment” in treatment or recovery. Entering the drug treatment system, which is dominated by the principles of abstinence embedded in the 12-Steps, was said to require a “leap of faith.”

In a description of the Grateful Life Treatment Center in northern Kentucky, it was noted that the wall above the desk of the center’s intake supervisor had a “Jesus bumper sticker.” Why add that detail unless you are trying to capture the scene in a particularly religious way? When describing treatment facilities modeling themselves on the 12 Steps, not only were recovering addicts said to be cheap labor, they were said to provide the “evangelism” to shape the curricula of the facilities. A resident of Grateful Life was noted to be “as close to a true believer as the program produces.”

At one point, the author of “Dying To Be Free,” Jason Cherkis, said AA came out “evangelical Christian movements.” More accurately, there is a clear historical connection between a nondenominational Christian movement popular during the 1920s and 1930s called the Oxford Group and Alcoholics Anonymous. The two cofounders of A.A., Bill W. and Dr. Bob met as a result of their personal association with the Oxford Group. A.A. approved books, such as Pass It On, Doctor Bob and the Good Oldtimers and AA Comes of Age freely acknowledge the connection and give further details about it. However, a crucial distinction made by A.A. within its 12 Steps is glossed over by Cherkis and others, namely the spiritual, not religious understanding of God and recovery embodied in the Twelve Steps.

Drawn from the thought of the American psychologist, William James, this distinction between religious and spiritual experience seems to underlie the widespread sense of generic spirituality in American culture today. The Varieties of Religious Experience  (VRE) by James had a fundamental influence on Bill W., the formulation of the Twelve Steps and the spirituality based upon them. In VRE James made a distinction between institutional and personal religion. Worship, sacrifice, ritual, theology, ceremony, and ecclesiastical organization were the essentials of what he referred to as institutional religion.

Personal religion/spirituality for his [James’] purposes was defined as “the feelings, acts, and experiences of [the] individual . . . in their solitude, so far as they apprehend themselves to stand in relation to whatever they may consider the divine.” In the broadest sense possible, this spirituality consisted of the belief that there was an unseen order to existence, and supreme good lay in harmoniously adjusting to that order.

Whether their disregard of the spiritual, not religious distinction is intentional or not, Cherkis and others give an incomplete and biased picture of Twelve Step recovery when they fail to note it. The very heart of Twelve Step spirituality is the permissibility of the individual to formulate a personal understanding of their “god.” So what unites members of Twelve Step groups like A.A. is the diversity of religious and spiritual belief permitted—even to accepting a lack of belief. I’ve written several other articles on the similarities and differences between the spirituality of the Twelve Steps and religious spirituality on this website. There are three particular articles that discuss the influences on the spiritual, not religious distinction of Twelve Step recovery: “What Does Religious Mean?”, “Spiritual Not Religious Experience” and “The God of the Preachers.”

Another example of how “Dying To Be Free” misrepresents the recovery philosophy of A.A. is the following. While introducing a discussion of Charles Dederich and the origins of Synanon, Cherkis said Dederich and others took a “hardline” message” from some of Bill W.’s written philosophy. Cherkis wrote: “Those who can’t stick with the program are ‘constitutionally incapable of being honest with themselves,’ reads the Big Book. ‘They seem to have been born that way.’” The two selective quotes were from the first paragraph of chapter five, “How It Works,” in Alcoholics Anonymous. Notice how the context of the complete paragraph changes your understanding of what Bill W. said in his “philosophy”:

Rarely have we seen a person fail who has thoroughly followed our path. Those who do not recover are people who cannot or will not completely give themselves to this simple program, usually men and women who are constitutionally incapable of being honest with themselves. There are such unfortunates. They are not at fault; they seem to have been born that way. They are naturally incapable of grasping and developing a manner of living which demands rigorous honesty. Their chances are less than average.

As Cherkis began to discuss the history of the expansion of drug treatment facilities in the 1960s, he quoted Nancy Campbell, a professor at Rensselaer Polytechnic Institute, as saying: “The history of 12-step came out of white, middle-class, Protestant people who want to be respectable.” She added that it offered community and belonging that was predicated on being normal, respectable and having a stake in mainstream society.  Campbell may be a historian, but she seems to have a distorted view of the early history of 12 Step recovery in A.A.

From the sociological perspective of labeling theory A.A. and other organizations based on their 12 Steps, like N.A. (Narcotics Anonymous), can at least partially be seen as social movements that seek to combat negative images associated with socially deviant drinking or drugging behavior, “in effect denying that their actions make them deviants.” This applies the idea of tertiary deviance, first described by John Kituse in: “Coming Out All Over: Deviants and the Politics of Social Problems.” Kituse noted that some people stigmatized as deviant (here as alcoholics) “rebel against their labels and attempt to reaffirm their self-worth and lost social status.” The above quote and reference to Kituse is found in a standard social science textbook by Clinard and Meier, Sociology of Deviant Behavior.  So part of Campbell’s assessment of 12 Step groups as social movements seeking to offer community and belonging, with a “stake in mainstream society” is accurate. However, the quote attributed to her glosses over the early history of A.A., which was the beginning of the 12 Step movement.

A.A. celebrates the anniversary of its founding on June 10, 1935. That was in the midst of the Depression. Bill W. and his wife Lois were living then in a house owned by her father on Clinton Street in New York City. In September of 1936, Lois’s father died and the house was taken over by the mortgage company, which allowed them to stay on for a small rental. In the midst of the Depression, they didn’t want the house to be empty. While struggling with “their acute poverty,” Bill was almost persuaded to accept a position as a paid alcoholism therapist at Towns Hospital, where he himself had been treated several times. He eventually declined the offer.

Almost two and a half years after the founding of A.A., Bill W. was jobless and Dr. Bob was in danger of losing his house. In 1938, through the charity of John D. Rockefeller Jr., $5,000 was approved for a fund that would pay off Dr. Bob’s mortgage and allow a weekly draw of $30 for each of them. Rockefeller told one of his associates afterwards: “But please don’t ever ask me for any more.” In 1939, as the Depression eased, the mortgage company was able to sell the Clinton Street house and Bill and Lois became homeless. They lived “as vagabonds,” as various places for two years. Bill W. and Lois eventually led a respectable, middle class lifestyle, but that wasn’t what it was like for them in the beginning of A.A.

This history is found in Pass It On, published by Alcoholics Anonymous World Services, Inc. In the early days of A.A., Bill W. repeatedly turned down offers to professionalize his work with A.A. This doesn’t entirely sound like a movement trying to gain white, middle class respectability. The Traditions of A.A., formally adopted in July of 1950, articulated this philosophy of non-professionalism and a focus on helping other alcoholics in the fifth, sixth and eighth Traditions.

Tradition Five Reads: “Each group has but one primary purpose—to carry its message to the alcoholic who still suffers.” Tradition Six reads: “An A.A. group ought never endorse, finance, or lend the A.A. name to any related facility or outside enterprise, lest problems of money, property, and prestige divert us from our primary purpose.” Tradition Eight reads: “Alcoholics Anonymous should remain forever non-professional, but our service centers may employ special workers.”

Alternative addiction treatment ideologies regularly attack A.A. as “religious,” ignoring or rejecting the spiritual-religious distinction A.A. made within the Twelve Steps from the very beginning. The abstinent-based recovery philosophy embedded in the Twelve Steps seems to be the primary target of these critiques. I see the same tendency in “Dying To Be Free.” The first part of this article addressed the biased portrayal of abstinent-based addiction treatment by Jason Cherkis in “Dying To Be Free.” The third and final part will address how it skimmed over the problems with MAT, specifically Suboxone.

02/18/16

American Polytheism

© vectomart | 123rf.com

© vectomart | 123rf.com

The Baylor Religion Survey looked “under the hood,” so to speak, of the commonly acknowledged fact of American religiosity. Consistent with other findings, it found that 85-90% of Americans said they believed in God, and 71.5% said they prayed at least once per week. Almost half (49.2%) said they attended church at least once per month. “In fact, under the surface American religion is startlingly complex and diverse. Americans may agree that God exists. They do not agree about what God is like, what God wants for the world, or how God feels about politics.” Let’s see what the Baylor researchers found out.

One of the intriguing aspects of the Baylor Religion Survey was how it assessed religious affiliation. Most surveys simply ask the person to select their affiliation or denomination from a list. But this has become increasingly problematic as more and more Americans lose a strong denominational identity through the rise of nondenominational congregations as well as congregations that minimize their denominational ties. I watched with interest as a large local church completed its building program and shed the “Assembly of God” part of its name to simply become “Church.” Rick Warren’s Saddleback megachurch is similar. How many people realize it is part of the Southern Baptist denomination? I didn’t.

What the Baylor researchers did was look beyond mere denominational affiliation. In addition to the typical checklist of denominations, they asked respondents to give the name and address of their places of worship. This enabled them to more accurately sort persons into broader religious traditions. By their calculations, Evangelical Protestants comprised 33.6% of their survey; Mainline Protestants were 22.1%; Catholics were 21.2%; the Unaffiliated were 10.8%; Other was 4.9%; Black Protestant were 5.0%; and Jewish were 4.9%. See the Survey for further information on these religious traditions.

The so-called “nones,” individuals not affiliated with any religious tradition, have been getting a lot of attention in the reporting on religious surveys lately. The Baylor Religion Survey found that 62.9% of American nones believed in God or some higher power. Most of these individuals (44.5% of the 62.9%) reported a belief in a higher power. There were 37.1% of nones who said they didn’t believe in a God or higher power, while 11.6% believed without any doubts and 6.9% sometimes believed in God or believed with doubts. Almost one third of the unaffiliated (31.6%) reported praying at least occasionally; 10.1% of those prayed daily. What comes to mind is the spiritual, not religious language and distinction made within Twelve Step groups.

Another intriguing aspect of the Baylor Religion Survey was how it used 29 questions about God’s character and behavior to get a sense of what people meant when they said they believed in God. They discovered there were two distinct dimensions of belief in God. The first dimension was God’s level of engagement or activity. This captured the extent to which the individual believed God is directly involved in worldly and personal affairs. The second dimension was God’s level of anger. This described the extent to which the person believed God is angered by human sins and tended towards punishing, severe, and wrathful characteristics.

From these two dimensions, the researchers separated their sample into four types of believers: Type A was the Authoritarian God; Type B was the Benevolent God; Type C was the Distant God; Type C was the Critical God. Type A believers scored above the mean on both the activity and anger dimensions. Type B believers scored above the mean on activity, but below the mean on anger. Type C believers scored above the mean on anger, but below the mean on engagement. Type D believers scored below the mean on both the dimensions. See the following figure taken from the Baylor study:

Baylor

What struck me about this way of assessing belief in God was that it captured more of a sense of how the respondents viewed God, closer to the sense of “God as you understand Him” in Twelve Step recovery. These types don’t neatly fit within a denominational category. You could potentially find all four types within one denomination.

Those who believe in an Authoritarian God represent 32% of the population. They think God is very involved in their lives and world affairs. He is responsible for global events like tsunamis and economic upturns. They also tend to feel God is angry and capable of meting out punishment to those who are unfaithful or ungodly.

Those who believe in a Benevolent God make up 23% of the population. They also see God as very active in their daily lives. But they are less likely to believe God is angry and that He acts in wrathful ways. Instead, they see God as a force of positive influence in the world who is less willing to condemn or punish individuals.

Believers in a Critical God comprise 16% of the population. They feel God does not really interact with the world. However, God still observes the world and views the current stat of affairs unfavorably. His displeasure will be felt in another life and divine justice may not occur in this world

Believers in a Distant God include 24% of the population. They think God is not active in the world; neither is He especially angry. These individuals tend towards thinking about God as a cosmic force, which set the laws of nature in motion, similar to deism. As such, God does not “do” things in the world; nor doe He hold clear opinions about human activities or world events.

When these views of God are used to sort through selected aspects of religiosity, there were some interesting results. Believers who saw God as active in personal and world affairs, (Type A and Type B), were significantly more likely to attend church services weekly, pray several times a day, believe that Jesus was the Son of God, and be biblical literalists.  See the following table derived from Table 8 in the Baylor Religion Survey.

Type A Authoritarian

Type B Benevolent

Type C Critical

Type D Distant

Attends church weekly

50.9%

31.5%

9.8%

7.8%

Never Attends

13.5%

8.2%

16.7%

41.5%

Prays several times daily

54.8%

31.7%

6.5%

7.0%

Never Prays

1.8%

2.5%

18.4%

38.7%

Biblical Literalist

60.8%

26.5%

10.2%

2.5%

Jesus is the Son of God

41.3%

27.8%

14.4%

16.0%

Denominational affiliation is not the whole story on American spiritual and religious practices and beliefs. While the Baylor Religion Survey and other research, such as that by the Pew Research Center, suggest that “nones” are becoming increasingly secular, there clear evidence that many still believe in some kind of a transcendent or higher power and pray at least monthly. The Baylor survey found that around 10% prayed daily. The Types of God used to categorize views of God in the Baylor Religion Survey illuminated an understanding of God that cuts across denominations and has some correspondence with the sense of “God as you understand Him” within the Twelve Steps.

This reflects a growing movement in American religiosity towards what William James described as personal religion in his seminal work, The Varieties of Religious Experience. Institutionally-grounded religious belief and practice is waning, while personal expression of a belief in God and spiritual practices such as prayer continues, even among those who see themselves as not religious. The distinction between institutional and personal religion first articulated by William James in The Varieties of Religious Experience seems to resonate with the modern spiritual, not religious distinction within many Twelve Step groups.