12/1/14

Look Before You Speak

© Panpalini | Dreamstime.com - Toad Photo
© Panpalini | Dreamstime.com – Toad Photo

I am concerned about an article I read recently on alcohol treatment, “The Best Treatment for Alcohol Use Disorder Your Addiction Counselor Isn’t Telling You.” It seemed like it was more of a rant than an attempt to constructively make a point. The author is an epidemiologist who wanted people to know that “medication is a vital key” in treating addiction. But some of the comments he made were surprisingly biased for someone who is “a published healthcare statistician and epidemiologist currently pursuing a doctorate in epidemiology.”

One example of this is a study from the Journal of Alcohol Studies that he linked in his article. He cherry picked how the study found that 29% of a sample of A.A. members said they received some pressure to go off their medication (of any type). But he failed to report that over half of the A.A. sample believed that using relapse-preventing medications “either was a good idea or might be a good idea.” Seventeen percent didn’t think that it was a good idea to take relapse-preventing medications; and only 12% said they would tell another member to stop taking it. Sixty-nine percent of these didn’t listen and continued taking their medication. The conclusions from the article’s abstract were:

The study did not find strong, widespread negative attitudes toward medication for preventing relapse among AA members. Nevertheless, some discouragement of medication use does occur in AA. Though most AA members apparently resist pressure to stop a medication, when medication is prescribed a need exists to integrate it within the philosophy of 12-step treatment programs.

He described the benefits of two medications for treating alcohol use disorder, Naltrexone and Campral (acamprosate) and claimed that: “ These medications are very likely the ones that your counselor or sponsor is not telling you about. In fact, the majority of the rehabs in the United States do not use any of this medication.”  The author made, but did not support that claim.

The rehab I work for part time knows of and supports the use of both of these medications and has done so for a number of years. A.A. sponsors might be violating their Traditions in recommending or telling people they sponsor that they should try Naltrexone or Campral. They certainly would be involved in ethically questionable advice-giving since their sponsor role is not as a doctor or an addictions professional.

The most disturbing claim was that “Naltrexone is an opioid inhibitor that has been FDA approved as a constant low dose (daily intake) or as a supplement prior to drinking.” He noted its use to inhibit cravings for chronic alcoholics, cautioning that it could “up-regulate” the opioid system and cause worse relapses when the person was off Naltrexone. Then he suggested that it was best served as an “emergency relapse drug.” From the article:

Patients, prior to relapse, have taken this drug and report significantly lower impact of their relapse. In fact, naltrexone works so well to reduce relapse that many alcoholics use it to successfully drink on a regular basis with very few reports of high binge drinking. It is entirely possible that rather than going to AA meetings, the majority of alcoholics in the near future can simply carry a bottle of naltrexone with them for drinking occasions.

I’ve reviewed information on Naltrexone from Medline Plus, WebMD, Drugs.com, and SAMHSA (Substance Abuse and Mental Health Services Administration) here and here. I did not find ANY indication that Naltrexone was “FDA approved” as a supplement prior to drinking. To be sure, Naltrexone is an FDA-approved medication for alcohol dependence. But there was no indication that Naltrexone was approved as a “supplement prior to drinking” or as an “emergency relapse drug” that “many alcoholics use it to successfully drink on a regular basis with very few reports of high binge drinking.”

There have been studies that indicated Naltrexone led to reduced drinking in both the amounts of alcohol and the frequency of drinking. And there have been studies where individuals used Naltrexone to limit or control their drinking, as with pharmacological extinction in the Sinclair Method. Here is an article written by John Sinclair, after whom the method was named. There is also information on the Sinclair Method here and on Facebook. Also see my article, “A ‘Cure’ for Alcoholism.” But Naltrexone is not FDA approved to limit, control or extinguish alcohol use at this time.

To make the claim as the author does—“It is entirely possible that rather than going to AA meetings, the majority of alcoholics in the near future can simply carry a bottle of naltrexone with them for drinking occasions”—is foolhardy, irresponsible, and dangerous. Also, it is a wrong interpretation of the state of current research into the use of Naltrexone with alcohol use disorders.

The most positive statement I found about Naltrexone in that regard on the above noted websites was in one of the SAMSHA publications, “Incorporating Alcohol Pharmacotherapies Into Medical Practice.” What follows is that statement:

Naltrexone appears to be effective for attenuating craving in people who are alcohol dependent (Monti et al., 1999, 2001). By blocking craving, naltrexone may enhance the ability of patients to abstain from drinking. By blocking the pleasure from alcohol, naltrexone also may reduce the amount of heavy drinking in those who do drink.

If he wrote the article as a rhetorical device to help people see how medications can be helpful when treating alcoholism, okay.  He accomplished that goal. It had generated 1276 comments as of 10/25/2014 when I last looked. But if he was attempting to give credible information as an epidemiologist on pharmacological treatments for alcohol use disorder, he did not succeed.

11/21/14

Make Me an Instrument of Your Peace

wjarek / 123RF Stock Photo
wjarek / 123RF Stock Photo

Back in the 1980s, Come to the Quiet by John Michael Talbot was one of my favorite cassette tapes. And his version of the “Peace Prayer of St. Francis” was one of my favorite songs on the tape. When I decided to write on the connection of the Peace Prayer to Alcoholics Anonymous, I discovered that John Michael Talbot is still around, making music and doing an evangelistic ministry. His look has changed. Now he sports a very long white and grey beard. Think ZZ Top and John the Baptist rolled into one.

The origins of the Peace Prayer of St. Francis are actually in 20th century France, not the writings of Francis of Assisi. In 1912 it appeared anonymously in a small French magazine, La Clochette (The Little Bell), published by a French priest, Father Esther Bouquerl. In 1915, it was sent to Pope Benedict XV and published the following year in the Vatican’s daily newspaper.  Around 1920, it was printed on the back of an image of St. Francis and titled “Prayer for Peace.” It was first attributed to St. Francis in 1927 by a French Protestant movement, The Knights of the Prince of Peace.

The first known English translation was in a 1936 book by Kirby Page titled: Living Courageously. Kirby was a Disciple of Christ minister and the editor of a pacifist magazine called “The World Tomorrow;” not to be confused with the long running radio and television program by Herbert W. Armstrong or the more recent 2012 political talk show hosted by Julian Assange.  Page clearly and specifically attributed the origins of the “Peace Prayer” to St. Francis of Assisi. During World War II and afterwards, it had a wide circulation as the “Prayer of St. Francis” especially through the books of Francis Spellman, who became the archbishop of New York City in 1939, the year the A.A. Big Book, Alcoholics Anonymous, was published. A.A.’s headquarters and Bill W., cofounder of A.A., were both in NYC.

In a December 1952 article for the AA Grapevine, Bill W. presented Francis of Assisi as an example of an individual who was able to practice “the spirit of Christmas” every day of the year. Bill thought that regardless of what an individual may call it, “the spirit of Christmas is in us all.” After describing the life of Francis and the vision Francis had after he “hit bottom” during a long illness, Bill presented the “Peace Prayer of St. Francis” as “the prayer he [Francis] so often spoke.” Bill then concluded his reflections stating that Francis left us a clear example of how to live our lives: “Freely ye have received; Freely give.”

When Bill W. wrote the essay for “Step Eleven” in the A.A. book, Twelve Steps and Twelve Traditions, he suggested it as a beginning for those trying to apply the meditation and prayer to recovery that the Eleventh Step encouraged. The Eleventh Step reads: “Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.” Within A.A., the Peace Prayer has become known as “the Eleventh Step Prayer.” In 1958, Bill wrote the “Prayer of St. Francis” in the AA Grapevine and described how he used Peace Prayer to overcome depression. He said:

Of course, I haven’t offered you a really new idea–only a gimmick [the Peace Prayer] that has started to unhook several of my own “hexes” at depth. Nowadays my brain no longer races compulsively in either elation, grandiosity or depression. I have been given a quiet place in bright sunshine.

A final indication of the importance of the Peace Prayer to Bill was that it was recited in a private memorial service when he died. And it was credited in Pass It On to be his favorite prayer. Here it is:

Lord make me an instrument of your peace

Where there is hatred,
Let me sow love;
Where there is injury, pardon;
Where there is error, truth;
Where there is doubt, faith;
Where there is despair, hope;
Where there is darkness, light;
And where there is sadness, Joy.

O Divine Master grant that I may not so much seek to be consoled
As to console;
To be understood, as to understand;
To be loved, as to love.
For it is in giving that we receive,
It is in pardoning that we are pardoned,
And it is in dying that we are born to eternal life.

 

Although Bill saw the Peace Prayer as applying to individuals of any faith background, to do so, the “Lord” and “Divine Master” of the prayer will have to be seen in the generic sense of God as we understood Him. Yet the Christian sense of who was “Lord” in the prayer was never in doubt. Even from its own anonymous beginnings it was referring to Jesus Christ. “If you confess with your mouth that Jesus is Lord and believe in your heart that God raised him from the dead, you will be saved. (Romans 10:9)”

Even if we look to the Peace Prayer as a blueprint to how all people should treat one another as Bill W. did, it elaborates the second greatest commandment of loving your neighbor as yourself (Mark 12:31). And when someone who does not confess Jesus as Lord still tries to live out the truth of the Peace Prayer in his or her life, we can say as Jesus did to the scribe in the Mark 12 passage, “You are not far from the kingdom of God. (Mark 12:34)”

11/7/14

Abandon Yourself to God

© Bonciutoma | Dreamstime.com - Walk To The Cross Photo
© Bonciutoma | Dreamstime.com – Walk To The Cross Photo

I remember hearing a sermon once on Romans 12:1, “I appeal to you therefore, brothers, by the mercies of God, to present your bodies as a living sacrifice, holy and acceptable to God, which is your spiritual worship.” The minister, George Stockhowe, said the problem with living sacrifices was that they are always trying to crawl off of the altar.

Several commentators have noted that the phrase, “the mercies of God,” in verse 12:1 is a succinct summary of what Paul has said up to this point in the epistle to the Romans. C. K. Barrett said that the proper response “is not to speculate upon the eternal decrees, or one’s own place in the scheme of salvation, but to be obedient.”  And the sacrifice is to be a living one. F. F. Bruce commented that the sacrifices of the New Testament did not consist of taking the life of others, “but in giving one’s own.”

The phrase “spiritual worship” can get scholars going because the Greek word used here for spiritual, logikos, only appears one other time in the New Testament (1 Pet. 2:2). Sifting through the various perspectives, I’d suggest we see Paul as saying that our living sacrifice is “your [true] spiritual worship.” So while there can be a variety of things that we do as “spiritual worship,” being a living sacrifice is real, true spiritual worship.

Oswald Chambers regularly addressed the topic of surrender and being a living sacrifice in his devotional classic, My Utmost for His Highest. Here are a few selections:

“It is of no value to God to give Him your life for death. He wants you to be a ‘living sacrifice,’ to let Him have all your powers that have been saved and sanctified through Jesus. This is the thing that is acceptable to God. . . . In sanctification, the regenerated soul deliberately gives up his right to himself to Jesus Christ. . . . If we do not sacrifice the natural to the spiritual, the natural life will mock at the life of the Son of God in us and produce a continual swither. . . . The only way we can offer a spiritual sacrifice to God is by presenting our bodies a living sacrifice. . . . This is always the result of an undisciplined spiritual nature. We go wrong because we stubbornly refuse to discipline ourselves, physically, morally or mentally.  .  . . Surrender is not the surrender of the external life, but of the Will; when that is done, all is done. There are very few crises in life; the great crisis is the surrender of the will. God never crushes a man’s will into surrender, He never beseeches him, He waits until the man yields up his will to Him. That battle never needs to be re-fought. . . . After surrender—what? The whole of life after surrender is an aspiration for unbroken communion with God. ” (My Utmost for His Highest, January 8, January 10; December 10; September 13)

There is a clear parallel here to the surrender thinking in recovery, as in these slogans: “I can’t, God can, I think I’ll let Him;” or: “I can’t handle this one God; please take over.” It’s also present in the Third Step: “Made a decision to turn our will and our lives over to the care of God as we understood Him.”

Although you won’t see this mentioned in A.A. literature, early AAs and its founders read My Utmost for His Highest in the early pre-Big Book years. Dick B., an historian on A.A., reported that early Akron A.A. meetings opened with prayer and a reading from the Bible or a devotional such as My Utmost for His Highest. Dr. Bob, his wife Anne, Bill W. and his wife Lois used the devotional. Dr. Bob and Anne used it on a daily basis. Lois mentioned in a notebook she kept between December 1934 and August 1937 that she really saw herself in the reading for July 22nd.

In his July 22nd reflection on Sanctification, Oswald Chambers commented there was a battle royal before sanctification; there was always something that resented the demands of Jesus Christ. Quoting Luke 14:26 on the cost of discipleship, Chambers noted that the struggle began as soon as the Spirit of God began to show us what sanctification meant–to hand our “simple naked self over to God”:

Am I willing to reduce myself simply to ‘me,’ determinedly to strip myself of all my friends think of me, of all I think of myself, and to hand that simple naked self over to God? Immediately I am, He will sanctify me wholly, and my life will be free from earnestness in connection with everything but God. (My Utmost for His Highest, July 22nd)

Finally, in the closing exhortation of the chapter, “A Vision for You,” from the Big Book, Alcoholics Anonymous, Bill W. said: “Abandon yourself to God as You understand God. Admit your faults to Him and to your fellows. Clear away the wreckage of your past. Give freely of what you find and join us.” And remember: living sacrifices will try to crawl off of the altar.

 

10/27/14

Conscientious Objectors to AA

image credit: iStock

Not all the drunk driving stories I’ve heard were tragic. One individual driving back from an out-of-state visit became lost on a rural road in the middle of the night. He saw a local police officer in the process of having another vehicle towed, so he stopped to ask directions. As it turned out, the officer was finishing up with a DUI arrest he had made earlier that night. Soon after the lost man lowered his window to ask for directions, he became the officer’s second DUI arrest of the night.

Another person returned to her downtown apartment after a long workday and was relaxing with a few glasses of wine. She answered an insistent knocking on her door from her landlord, who informed her the city would tow her car in the morning if she didn’t move it. The officer who arrested her for DUI was not sympathetic. The woman was particularly incensed because she previously thought she was doing the right thing by sleeping it off in her car instead of driving home from a restaurant. But she was still charged with a DUI when a police officer woke her in her car a few hours later.

In many states, multiple offenders have the opportunity to receive alternate sentencing to DUI courts or treatment programs in lieu of jail time. The American Automobile Association (AAA) reported that there are currently more then 1900 DUI/Drug Courts across the country.  And there is evidence that these programs reduce recidivism. The vast majority of DUI episodes are caused by a small group of repeat offenders. Estimates suggest that 3-5 percent of drivers account for around 80 percent of the DUI episodes.

These courts are mostly post-conviction, meaning that the accused must plead guilty or be convicted to participate in them. . . . Compliance with treatment and other court-mandated requirements is verified by frequent testing, close community supervision and interaction with the judge in non-adversarial court review hearings.

A frequent requirement of DUI courts and other legal-based substance-abuse intervention programs is for the individual to attend some sort of a treatment program and Alcoholics Anonymous meetings. And some individuals raise strong objections to the court-ordered AA attendance.

One former court mandated attendee of AA meetings viewed her attendance as the government prescribing “prayer under the threat of imprisonment.” As an atheist, she found it difficult to believe she had an imaginary friend. A court ordered treatment program she was in structured its group therapy sessions with opening and closing prayers (the Lord’s Prayer and the Serenity Prayer). She reported that when she took a bathroom break during the “Our Father,” she was told she couldn’t leave during the prayer.

Another individual is suing the state of Nebraska, alleging his constitutional rights were violated because he was required to attend AA meetings even though he objected to its religious foundation: “I do not believe the state should be telling anybody to go to them, and it cost me a career as a massage therapist because I didn’t go.” Somehow I think there is a little bit more to the loss of his masseuse license.

When I hear of experiences like these, I wonder what’s missing. Was the woman really reprimanded for not participating in a prayer or for leaving the group without permission? Did the Nebraska man lose his career because he refused to attend AA meetings, or because an alcohol-related arrest violated a professional code of ethics?  I think many of the conscientious objectors to AA attendance on nonreligious grounds are erecting straw man arguments to knock down because they are angry about the legal consequences of their drinking—and not simply their forced attendance at “religious” gatherings.

AA meetings have been legally designated as “religious” within the U.S. The court cases that successfully challenged mandated meeting attendance were all brought by parolees, probationers and inmates. They argued that mandated attendance was a violation of the Establishment Clause, which requires “governmental neutrality with respect to religion and a wall of separation between Church and State.” So it seems there will have to be an ongoing adjustment to how governmental agencies address this perceived violation of Church and State through mandated AA attendance. This is a state-by-state battle for now.

However, I don’t think it is a forgone conclusion that A.A. is “religious” because the courts have said its literature reflects elements common to most theistic religions. Yes, there are clear elements of religious dogma if the “Our Father” or “The Lord’s Prayer” is recited at meetings. But that does not occur at all A.A. meetings and I’ve not known where it is expected of anyone to recite the prayer.

There are conceptions of what constitutes a “religion” and a “church” that do not equate any and all belief in God or a Higher Power as religious dogma. If these views were to be legally recognized, then mandated A.A. attendance would not necessarily be a violation of the Establishment Clause. I’ll look at this in some future posts. But back to the conscientious objectors to AA attendance.

Erica Larsen on AfterPartyChat is more sympathetic to these individuals than I am. She empathizes with their “feelings of alienation from AA’s more Christian elements. The whole Higher Power thing kept me out of any 12-Step programs for years, so I get it. I totally get it.” But now that she is actually involved in 12-Step fellowships, she believes it was one of the best personal decisions she ever made. “Getting over the God thing was surprisingly easy once I decided to actually give meetings and sponsorship a try.” But she still wanted to just shake the guy in Nebraska and tell him to just go to the meetings.

 

10/6/14

As Harmless as Aspirin?

tyfon / 123RF Stock Photo
tyfon / 123RF Stock Photo

The province of Saskatchewan seems an unlikely place to give birth to “psychedelic psychiatry”  (See Erika Dyck’s article, “Hitting Highs at Rock Bottom” and a review of her book Psychedelic Psychiatry), but it’s true. In October of 1951 a British psychiatrist named Humpry Osmond became the deputy director of a Canadian Mental Hospital in Weyburn, Saskatchewan. He immediately organized a biochemical research program in order to continue the work he had begun with hallucinogens while he was at St. George’s Hospital in London.

Not only did Osmond coin the term psychedelic, he seems to be among the first to hypothesize a chemical imbalance theory for both schizophrenia and alcoholism. Initially interested in the therapeutic properties of mescaline, Osmond noticed that mescaline produced reactions similar to schizophrenia. These findings led him to conjecture that “schizophrenia was caused by a chemical imbalance in the brain.” Oh, and he was a pioneer researcher into the psychotherapeutic benefits of mescaline and LSD for alcoholism and various mental health disorders.

Osmond heard of the discovery of lysergic acid (LSD) by Albert Hoffman and tried it himself. He discovered that LSD was more powerful than mescaline and that it produced profound changes in consciousness. By inducing a new level of self-awareness, Osmond theorized LSD could have therapeutic benefits for individuals suffering with schizophrenia. Some of his early volunteers in LSD experiments described this feeling as “a new sense of spirituality.”

According to Osmond’s co-researcher, Abram Hoffer, the idea to try LSD with alcoholics occurred one evening in 1953, when they thought that: “LSD experiences were remarkably similar to descriptions of delirium tremens, or the effects of an alcoholic ‘hitting bottom.’” They wondered if a controlled LSD-produced delirium would help alcoholics stay sober. In 1953, they gave LSD to two alcoholic patients. One person (a female) stopped drinking immediately and the other (a male) stopped six months later. Over the next ten years they tried this procedure on over 700 patients and claimed the results were similar to that first experiment. One of those alcoholics was Bill W., cofounder of Alcoholics Anonymous.

Bill’s involvement with LSD came about through his friendships with Gerald Heard, a British philosopher, and Aldous Huxley, author of the classic novel Brave New World. Bill had been a friend of Heard’s since 1944. He met Huxley through Heard. According to Pass It On, the A.A. book about Bill and the origins of Alcoholics Anonymous, it was Huxley who referred to Bill as “the greatest social architect of the century.”

Under the supervision of Humphry Osmond, Huxley used mescaline for the first time on May 5, 1953. Huxley’s short book about his experience with mescaline, The Doors of Perception, was published in 1954. Through Heard and Huxley, Bill was introduced to Osmond and Hoffman. At first, when Bill heard about Osmond’s work with LSD, he was “extremely unthrilled.” Bill was “very much against giving alcoholics drugs.” He became interested, though, when he heard Osmond and Hoffman were getting results.

Under the guidance of Gerald Heard, Bill took LSD for the first time on August 29, 1956. He was enthusiastic about his experience. He felt it helped to eliminate barriers that stood in the way of an individual’s direct experience of the cosmos and God. According to Nell Wing, then secretary to A.A., “He had an experience [that] was totally spiritual, [like] his initial spiritual experience.” Among the friends and family whom Bill convinced to try LSD was his wife Lois and his spiritual advisor, Father Ed Dowling. Watch a 1950s video of an LSD session and a discussion of its effects by Gerald Heard here.

In a letter he wrote to Sam Shoemaker in June of 1958, Bill said that he took LSD several times and had collected considerable information about it. He felt that the negative information about its “awful dangers” was far from the truth. He thought the experiments by early LSD researchers like Osmond and Hoffman showed it had no physical risks at all. “The material [LSD] is about as harmless as aspirin.” Presciently he said: “It would certainly be a huge misfortune if it ever got loose in the general public without a careful preparation as to what the drug is and what the meaning of its effects may be.”

Bill was aware of the potential dangers to A.A. that his participation in the LSD experiments could have. “I know that I must not compromise its future and would gladly withdraw from these new activities if ever this became apparent.” By 1959 Bill had withdrawn from the LSD experiments.

Despite Bill’s assertion that LSD is about as harmless as aspirin, evidence now suggests there are several potential problems with LSD. It can temporarily impair your ability to make sensible judgments and understand common dangers. So you are more prone to accidents and injuries. It may cause temporary confusion, give you problems with abstract thinking, memory and attention span.

It can also trigger panic attacks or feelings of extreme anxiety. There have been some cases of LSD induced psychosis in seemingly healthy people. Individuals with schizophrenia and depression can see their symptoms worsen under the influence of LSD. Chronic use of LSD “alters gene expression profiles in the medial prefrontal cortex.” Many of the processes altered by chronic LSD use have also been implicated in the pathogenesis of schizophrenia.

The recreational use of LSD was entirely unexpected to Albert Hoffman, the discoverer of LSD, who said:

I had no inkling that the new substance would also come to be used beyond medical science, as an inebriant in the drug scene. Since my self-experiment had revealed LSD in its terrifying, demonic aspect, the last thing I could have expected was that this substance could ever find application as anything approaching a pleasure drug.

09/26/14

Our Papa Who Art in Heaven

© Master2 | Dreamstime.com - Lord's Prayer In Internal Passageway Photo
© Master2 | Dreamstime.com – Lord’s Prayer In Internal Passageway Photo

Verses 9 to 13 in the sixth chapter of the Gospel of Matthew are familiar to anyone in Christian churches as “The Lord’s Prayer” or the “Our Father.” Emmet Fox said it was “the most important of all Christian documents;” the best known and most often quoted of all the teachings of Jesus. Easily memorized, it has been recited publically and privately from the early days of the church. “It is indeed, the one common denominator of all the Christian churches.” The Lord’s Prayer is a model for our praying—“Pray then like this.” (Matt. 6:9) It also has parallels to the principles of recovery embedded in Twelve Steps.

In Matthew 6:1, Jesus cautioned his hearers against public displays of righteousness. Essentially he said that if you make a public display of being pious, you aren’t really being spiritual. He then proceeded to look at the three main aspects of Jewish piety: giving to charity (2-4), prayer (5-15) and fasting (16-18).

Matthew 6:5-8 begins: “And when you pray, you must not be like the hypocrites.”  Here is the second thing to unlearn if you want to practice true spirituality—don’t make a big show out of praying! In fact, find a way to pray in secret. God sees you. Also, don’t babble on and on, thinking that because you have a lot to say, God is impressed with your eloquence—He isn’t. Then Jesus drops a bomb: “Your Papa knows what you need before you ask him.”

New Testament scholars suggest that when the Greek word for Father appears in the Gospel prayers, the Aramaic word  ’abba was originally used in conversation. ’Abba was the equivalent of an infant babbling “Papa” to his father. To his audience, Jesus was suggesting an uncomfortably familiar form of address to God in prayer. Pious Jews wouldn’t even spell God’s name completely, and Jesus was referring to him as ’abba! One commentator said “Christians should consider God as accessible as the most loving human parent.” The hypocrites used flowery, eloquent language when they prayed. Jesus says don’t be like them—come to papa, who already knows what you need.

“Our Father in heaven, hallowed be your name.” Our Father links the person praying to all other believers. I am reminded here that the first word of the First Step is also plural, We, connecting the individual alcoholic to all others in A.A. The intimacy of praying to ’abba is counterbalanced by His presence in heaven. We can come into the presence of the creator of the universe, knowing He is our ’abba. We can approach the God of the universe in all our prayers.

In the chapter “We Agnostics,” of Alcoholics Anonymous, Bill W. wrote that alcoholics were faced with a crisis they could not postpone or evade. They were confronted with the question of faith. “God either is, or He isn’t. What was our choice to be?” Wilson went on to say that deep down in every person was the fundamental idea of God. Faith in some kind of God was a part of being human. “We found the Great Reality deep down within us.”  The God of heaven was near to us. In Him we live and move and have our being (Acts 17:28). Bill ended his essay with the following declaration: “When we drew near to Him He disclosed Himself to us!”

“Your kingdom come, your will be done, on earth as it is in heaven.” When Jesus heard that John the Baptist was imprisoned, he began preaching as John had in Matthew 3:2, “Repent, for the kingdom of heaven is at hand.” (Matt. 4:17)  So here in verse 6:10, we are to pray that God’s will be done as perfectly on earth as it is in heaven. Leon Morris said: “In heaven God’s will is perfectly done now, for there is nothing in heaven to hinder it, and the prayer looks for a similar state of affairs here on earth.” Not our will, but God’s will be done.

I hear an echo of surrender to the will of God in A.A.’s Third Step here, where the individual is called to submit their will and life to the care of God as they understand Him. In the entry for August 26th, Twenty-Four Hours a Day said that if we still cling to something, we must sincerely ask for God’s help to let go of it. “We must say: ‘My Creator, I am now willing that you should have all of me, good and bad.’” The last paragraph of the “Step Three” essay in Twelve Steps and Twelve Traditions says:

In all times of emotional disturbance or indecision, we can pause, ask for quiet, and in the stillness simply say: “God grant me the serenity to accept the things I cannot change, courage to change the things I can, and wisdom to know the difference. Thy will, not mine, be done.”

We’re not finished yet with our look at the Lord’s Prayer, but will stop here for now. Part of true spirituality is recognizing that we can approach the Creator of the universe in prayer as simply and as easily as an infant approaches his or her “papa.” And our attitude in prayer should be for God’s will to be done. I often use the Serenity Prayer in counseling to help people discern the will of God in their life. When I do, I encourage them to not only say it, but to work and apply it. Because if they do, then God’s will shall be done on earth. Do you approach God in prayer as if you are approaching a loving Father?

See the second part of this reflection on the Lord’s Prayer in “A Daily Reprieve.”

This series is dedicated to the memory of Audrey Conn, whose questions reminded me of my intention in seminary to look at the various ways the Sermon on the Mount applies to Alcoholics Anonymous and recovery. If you’re interested in more, look under the category link “Sermon on the Mount.”

09/22/14

Won’t Money Spoil This Thing?

image credit: iStock
image credit: iStock

In November of 1937, Bill Wilson and other early A.A. members were asked this question by Albert Scott when they met with him and others in a meeting held in John D. Rockefeller’s private boardroom. The then unnamed fellowship was looking for financial support from Rockefeller for their idea to develop a small specialized hospital to treat alcoholics. In the end, only $5,000 was approved to pay off the mortgage of Dr. Bob Smith’s home and provide a weekly draw of $30 for both Bill and Dr. Bob. Bill was bitterly disappointed at the time because he had envisioned a chain of treatment hospitals staffed with paid A.A. workers.

That wasn’t the end of Bill’s vision for the professionalism of the A.A. way. In his essay on the Sixth Tradition, Bill said “We tried A.A. hospitals—they all bogged down.” He related other outside attempts of education and reform that ultimately led to the conviction A.A. should not endorse any related enterprise, regardless of how good it seemed. “We of Alcoholics Anonymous could not be all things to all men, nor should we try.”

This “school of hard knocks” resulted in the formal acknowledgement of its non-professionalism within the Twelve Traditions. 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.” This primary purpose, embodied in Tradition Five, was “to carry its message to the alcoholic who still suffers.” Tradition Seven further voiced what was called A.A.’s “collective poverty” in stating that: “Every A.A. group ought to be fully self-supporting, declining outside contributions.”

The clear language of Tradition Eight states: “Alcoholics Anonymous should remain forever nonprofessional.”  Bill began his essay with this paragraph:

Alcoholics Anonymous will never have a professional class. We have gained some understanding of the ancient words, “Freely ye have received, freely give.” We have discovered that at the point of professionalism, money and spirituality do not mix. Almost no recovery from alcoholism has ever been brought about by the world’s best professionals, whether medical or religious. We do not decry professionalism in other fields, but we accept the sober fact that it does not work for us. Every time we have tried to professionalize our Twelfth Step, the result has been exactly the same: Our single purpose has been defeated.

It isn’t too hard to find someone critical of Alcoholics Anonymous or Twelve Step recovery these days. One of these critics is Dr. Lance Dodes, author of The Sober Truth. Dr. Dodes has professional credibility. He is a trained psychoanalyst; a retired assistant clinical professor of psychiatry at Harvard Medical School; the former director of the substance abuse treatment unit of McLean Hospital and more.

Listening to his interview on NPR, you will here him claim that: “the success rate of AA is between 5 and 10 percent.” And then he stated that the studies that have claimed to show that AA is scientifically useful are “riddled with scientific errors.” Further, A.A. is also “harmful to the 90 percent who don’t do well.” Significantly, he noted where A.A. describes itself as a “brotherhood” (or fellowship) rather than a treatment.

A.A. is not treatment, but often gets lumped in with the Rehab industry, as within the subtitle of Dodes’ book: “Debunking the Bad Science Behind Twelve-Step Programs and the Rehab Industry.” Dr. Dodes is just the newest in a long line of critics of both A.A. and the addiction treatment industry. His dismissed studies supporting the usefulness of A.A. as “riddled with scientific errors,” and declared that: “AA probably has the worst success rate in all of medicine.”

Another long time Twelve Step recovery critic is Stanton Peele. Dr. Peele has been around since 1975, when he was the co-author of Love and Addiction. His latest book is Recover! Stop Thinking Like an Addict and Reclaim Your Life with The PERFECT Program. I’ve read several of his other books and found some of his thinking useful. One idea from The Diseasing of America that I’ve used regularly over the years was his distinction between three generations of “disease” (physical ailments, mental disorders, and addictions). You can read his recent thoughts on addiction and recovery in these blog posts on The Fix: “The New Recovery” and “Do Not Fold, Spindle, or Mutilate People into AA.”

Because of its traditions, (Tradition Ten: “Alcoholics Anonymous has no opinion on outside issues; hence the A.A. name ought never be drawn into public controversies.”) A.A. will not respond to these criticisms. So if you want more information on A.A., you’ll have to go to some open A.A. meetings and see for yourself what A.A. is all about. They don’t charge admission; it’s free. You can also subscribe to this blog and receive a free copy of my ebook, “The Age of Miracles is Still with Us,” which examines data from periodic membership surveys by A.A.

If you want to know more about what Drs. Dodes and Peele think about A.A., try their latest books: Recover! for $16.66 or The Sober Truth for $20.50 on Amazon.

 

08/29/14

Don’t Blow Your Own Horn

pixelsaway / 123RF Stock Photo
pixelsaway / 123RF Stock Photo

The spiritual substance of anonymity is sacrifice. . . . Moved by the spirit of anonymity, we try to give up our natural desires for personal distinction. . . . We are sure that humility, expressed by anonymity, is the greatest safeguard that [we] can ever have.”

Matthew 6:1 cautions against the practice of a public display of righteousness or piety, because if you do, that is all the reward you get. Verses 2 to 18 then looks at three basics aspects of Jewish piety: almsgiving or charity (2-4), prayer (5-15) and fasting (16-18). These three are representative of all other “acts of righteousness.” The message is clear. If you make a public display of your piety, you aren’t actually being pious.

There wasn’t social security or welfare in Biblical times. Deuteronomy 15:11 said there would always be poor people. “Therefore I command you, ‘You shall open wide your hand to your brother, to the needy and to the poor, in your land.’” So voluntary charity and contributions to the poor were one of the three most important demonstrations of Jewish piety. But when you gave to charity, Jesus said, don’t make a big deal about it—don’t blow your own horn. “Beware of practicing your righteousness before other people in order to be seen by them.” (Matt 6:1)

Individuals who didn’t give anonymously were fake—they were play-acting. They were hypocrites.  Their words and actions were done for effect and not truly because they had a concern for others. What they were really trying to do was gain a reputation for righteousness. “Thus, when you give to the needy, sound no trumpet before you as the hypocrites do in the synagogues and in the streets, that they may be praised by others.” (Matt 6:2)

The Mishnah (the written record of the Judaism’s Oral Torah) spoke of a “Chamber of Secrets” in the temple where the devout Jew could leave gifts in privacy. The poor of a good family would come later to receive help without knowing who their benefactor was.  Leon Morris in his commentary on Matthew noted that the Torah said: “A man who gives charity in secret is greater than Moses our Teacher.” So someone making a big deal about giving to charity was violating the spirit of the commandment in Deuteronomy at the same time they were fulfilling the letter of the commandment. “But when you give to the needy, do not let your left hand know what your right hand is doing.” (Matt 6:3)

The standard set by Jesus here in the Sermon on the Mount out-midrased even the Chamber of Secrets in the temple: Give so anonymously that even your left hand does not know what your right hand is doing! There was no wiggle-room. When you made a public display of your giving, you were not being charitable.

D. A. Carson referred to this as “pseudo-piety.” Christians, he said, must not delude themselves that all giving is pleasing to God, or that giving itself is an act of righteousness. “The human heart is too crafty to allow so simple a suggestion to stand.” Anonymous piety or spirituality neutralizes the instinctual action of the human heart to say: “Look at me!” And anonymous spirituality is the heart of Twelve Step programs like Alcoholics Anonymous, A.A.

One of the spiritual parallels between A.A. and the church is the teaching on anonymity found within Matthew 6:1-4 and A.A.’s Twelfth Tradition: “Anonymity is the spiritual foundation of all our traditions, ever reminding us to place principles before personalities.” Both Twelve Step recovery and biblical Christianity see anonymity as essential for true spirituality. The above opening quote was from Bill Wilson’s essay on Tradition Twelve in Twelve Steps and Twelve Traditions. The only change was where I substituted the word “we” for “Alcoholics Anonymous” in the original essay.

In July of 1955 Sam Shoemaker, an Episcopal minister, spoke at the convention commemorating the 20th anniversary of A.A.’s founding. He believed A.A. was one of the great signs of spiritual awakening in our time. Shoemaker also thought A.A. had indirectly drawn its inspiration and motivation from the insights and beliefs of the church. When Bill Wilson had introduced Sam to the convention, Wilson acknowledged that Shoemaker himself was the connection between A.A. and the church: “It is through Sam Shoemaker that most of A.A.’s spiritual principles have come.” In his closing remarks, Shoemaker said:

Perhaps the time has come for the church to be reawakened and revitalized by the insights and practices found in A.A. I don’t know any fields of human endeavor in which the Twelve Steps are not applicable and helpful. I believe A.A. may yet have a much wider effect upon the world of our day than it has already had and may contribute greatly to the spiritual awakening which is on the way.”

One of the best ways someone can be reawakened and revitalized is by applying the A.A. principle of anonymity to their spiritual life. The discussion here looked at how it was applied by Jesus in his teaching on alms giving. But anonymity is relevant to all other expressions of piety—even prayer and fasting. Don’t let your left hand know what your right one is doing! Practice your piety before God, not other people. Don’t blow your own horn.

This series is dedicated to the memory of Audrey Conn, whose questions reminded me of my intention in seminary to look at the various ways the Sermon on the Mount applies to Alcoholics Anonymous and recovery. If you’re interested in more, look under the category link “Sermon on the Mount.”

07/28/14

They Tried to Make Me Go to Rehab

dutourdumonde / 123RF Stock Photo
dutourdumonde / 123RF Stock Photo

Amy Winehouse famously opened her hit song Rehab with the line: “They tried to make me go to rehab but I said, ‘No, no, no.’” The song’s mind-set is the attitude of many who have had to go to “rehab.” Sometimes people just don’t want to stop using drugs or drinking alcohol. And they REALLY don’t like hearing from someone else that they should stop. I work part time as a therapist for a drug and alcohol partial hospitalization program and could see Rehab being the treatment program’s theme song if we ever became a reality TV show.

A yearly survey done by the federal government, The National Survey on Drug Use and Health (NSDUH) estimated in 2007 that of the 19.3 million people who needed treatment for an alcohol use problem, 17.7 million (92%) did not receive it. I’m simply noting here that the vast majority of people who would say “No, no, no” to a rehab recommendation can and do avoid it.  But what about that 8%, those 1.6 million individuals who get to “go, go, go” to rehab?

Reluctant rehabbers through the legal system can be quite resentful when they are court ordered to attend A.A. (Alcoholics Anonymous) meetings. One such person who had a bad experience is Juliet Abram, writing in The Fix’s blog section. Her post has the provocative title: “Activists or AA Bashers?” She has her own blog, A.A.R.M.E.D. with Facts (Against Abuse in Recovery Meetings & Eliminating the Danger) and a Facebook page. Clearly, she doesn’t like A.A. and seems to have made her critique of it part of her lifestyle changes (I don’t know if she’d want the term “recovery” used). I want to share some of my thoughts on her post, “Activists or AA Bashers?” here.

She objected to the spirituality of A.A., saying it made her uncomfortable to talk about it. With a year left on probation, she started an S.O.S. (Secular Organization for Sobriety) meeting and was told by her probation officer that refusing to go to A.A. could lead to jail time. She also said: “I believe it is beyond the government’s scope of power to prescribe prayer under threat of imprisonment.”

First, it appears she was “court ordered” to 12-Step meetings for the third time, meaning three OVIs (operating a vehicle under the influence). DrivingLaws.org indicated that in Ohio, with a 3rd offense, she faced 30 days to 1 year in jail, a 1 to 10 year license suspension, and $350 to $1,500 in fines and penalties. The higher the BAC level and the more frequent the OVI offenses, the greater the consequences. I’d be mad too. But was going to A.A. meetings and probation initially offered to her instead of jail time? If it was, that’s not a bad deal, even for an atheist.

The threat by her probation officer doesn’t sit right with me unless part of her probation requirements was that she had to attend A.A. or other 12 Step meetings. Then she could potentially face jail time for a probation violation. Her S.O.S. meeting should count for at least one weekly meeting. Maybe she was expected to go to more and didn’t have easy access to alternatives to the A.A. meetings she despised. She also could have had a “hard ass” probation officer. She could have been resistant and challenging to him, which drew the threat of jail time.

Her rhetoric about the government proscribing prayer under threat of imprisonment is over the top. I’ve not heard of forced prayer at A.A. meetings; even those in the Cleveland area. The Cleveland area is historically “hard core.” Dr. Bob lived just south in Akron. But forced prayer is not what happens at an A.A. meeting.

In the A.A. published book, Pass It On, is the story of how the A.A. message reached the world. There, Bill Wilson described how changes like the phrase “God as we understand Him” in the Third Step were suggested as a concession “to those of little or no faith.” These changes were “the great contribution of our atheists and agnostics. They widened our gateway so that all who suffer might pass through, regardless of their belief or lack of belief.” (emphasis in the original)

In 1961, Bill Wilson wrote in the AA Grapevine, “Our concepts of a Higher Power and God—as we understand Him—afford everyone a nearly unlimited choice of spiritual belief and action.”  He suggested that this was perhaps the most important expression in be found in the entire vocabulary of A.A. Every kind and degree of faith, together with the assurance that each person could choose his or her own version of it opened a door “over whose threshold the unbeliever can take his first easy step into . . . the realm of faith.”

The spiritual aspects of A.A. aren’t forced upon anyone. And if there are individuals or a group who sees it as their mission for a newcomer to “get the spiritual angle,” there are plenty of others who aren’t like that. Try an experiment. Pay for access to the A.A. journal, The Grapevine. Then do a search on atheist or atheism and read some of the articles that go back to the 1940s. They seemed to have worked through the spiritual angle to be able to take what they needed for recovery, despite the “God stuff.”