Taking a break

I’m currently having a bit of a break from my three-meeting-per-week AA schedule because, to put it bluntly, I got the shits with it. I’m still talking regularly with my sponsor, members and friends, but the meetings were and are doing my head in.

Maybe I’ve been going to too many of the same meetings and hearing similar things from similar people too often?

It’s not that I don’t have anything to learn about my own sobriety and addictive nature, far from it. But, currently, it is the form and structure, the ritual and symbolism of AA, that I’m focussing on rather than the stories themselves. Maybe Antze was right all along?

The repetition of the same old tropes has me bleeding at the ears, when only a few months ago those same sayings (Keep it Simple! Easy does it!) were a salve for broodiness and fresh insecurities about the future. But, rather than chuck AA in the bin, I’ve just backed off my participation for the moment, and that’s ok

I’ve been particularly miffed at the religiousity of some members in AA. This is in addition to someone close to me purporting to have had a born again conversion while, at the same time, behaving like a bit of an arse.

Maybe its the recent, well-publicised shifts to the right in Australian political discourse, where a Prime Minister has been brought down in part by a government chasing the votes of disinfranchised, mostly white, Christian, poorly educated people living in rural and regional electorates in Queensland. This is a reflection of a broader shift internationally, where people who feel like they have not benefited from globalisation, who have lost their jobs to technology or competition, or who haven’t had a wage increase above inflation for years, are embracing populist candidates.

Leaders are appealing to humanity’s worst instincts, like nativism, and racism, whipping up unfounded fear and anger at African migrants in Melbourne, then cleansing their moral responsibilities at Church on Sundays. Our new PM, an evangelical, touted his role in establishing Australia’s inhumane refugee policy as a reason for his elevation. Like locking up decent human beings fleeing war and persecution, children and adults, with no release date on tropical gulags is a worthy credential for leading a nation.

I will say this: I avoided going out in Canberra last Wednesday and Thursday night in fear of encountering maruanding members of the Government’s Christian Right.

If you are reading this and suspect my God-botherer resentment is back, then you would be correct!

I’m not going to drink over it today. Someone else’s beliefs aren’t my business. But I live in a democracy and have a vote, and so do you (I hope) 🙂

Lost legs

I went back to visit my wife on the tiny island where she is working. I was anxious and had been wondering how things would go, with many things needing to be said. It was also a chance to have a much needed break from a job that I can’t decide if I love or hate.

The old guys at the market were still in their usual spots, drunk by 10am, same as always, lurching between bags of carrots and onions, swigging bottles of hopi, an island home brew. One poor sod lost his legs and then his bottle in a shattered mess of glass and man. Some people treat him kindly, like a sick brother. Most keep their distance. Some teenagers laugh.

It’s easy to feel that you’re losing your legs too after a day at sea, and certainly so after eyeballing a 15m animal underneath it, backed up by a posse of her mates.

They say people have two types of responses to seeing adult Humpback whales with nothing other than a bit of glass, some rubber and a plastic tube, flippering wildly. Some laugh. Others cry. I did both and simultaneously fogged up my mask and inhaled water: not recommended.

Then a 3m swell hit, I got some good waves and things felt good.

Inevitably, some conversations have to be had.

Try as I may to change, I am an Australian creature that thrives at home in routine.

I also realised I am distinctly not suited to the expat lifestyle and culture. We could say the alcohol doesn’t agree with me. But it’s more than that.

My wife and I grew apart and are now very different people to the ones who met a decade ago. We are no longer compatible and have separated.

AA taught me that I have no right to try to change other people, just as other people have no right to try and change me. AA does not say that recovering alcoholics have to roll over and appease people, because doing so creates resentments. I’ve realised that my tendency to want to please people, including those I love, erodes my autonomy.

Speaking of significant changes, my four-legged best friend became three-legged on Monday. He’s dealing with it well, doped to the eyeballs on Opiate Allsorts, having his every need attended to (including being hand fed poached chicken and rice by his very concerned human, omnomnomnom).

Poor bastard lost his leg chasing a tennis ball.

Things wear out as you get older. A snapped Anterior Cruciate Ligament in a knee became surgery and  a post-operative staphylococcus aureus infection that basically ate the knee joint from the inside out. These things happen in human surgeries every day around the world too.

Anyway, I’m grateful to report that, after a bit of a tumultuous run, I seem to be still putting one foot in front of the other, with my three-legged mate beside me and lots of two-legged ones for support and company.

 

 

 

 

The Beagle

I guess I should probably explain my pseudonym. In AA, we don’t have pseudonyms and usually follow a standard form {First Name}{Last Initial}. Tenured academics don’t use pseudonyms because if they didn’t put their names to things they’d be out of a job. Publish or perish and all that.

But me? To write honestly about addiction, I need to be able to let it all hang out. Since some of the stuff that hangs out might not look so good on a resume or CV, I need a pseudonym for now.

Could it be a reference to HMS Beagle, that unassuming Royal Navy vessel that carried the naturalist Charles Darwin on his famous voyage that led to the development of his theories of natural selection and evolution?

No, not quite.

Truth be told, the Beagle is just an old nickname that I got given during my early 20s.

A quick whiff of the breeze and friendly dog at the customs counter knows what’s what.

Stop wagging your tail and get away from me you bastard.

This is not to say that all sniffer dogs are druggies – let’s not make rash generalisations. Neither am I.

But, since a young age I have always kept my eyes and ears open, and have been fascinated with how and why people seek to alter the way they feel. In short, I have always known who to ask for various things, but have never been shackled to other drugs like I have been to alcohol.

Also, I have always felt oddly at ease interacting with people who others find scary. That’s mostly down to my gender and physical characteristics. I’m big enough to make people think twice about violence, and disarming and friendly enough that nobody would ever try. Respectful? Tick. Discreet? Shh.

Librarians love me too. I have niche demographics.

That said, I did have a loaded shotgun pulled on me once during fieldwork when I forgot to ring ahead before visiting someone for an interview. I got the interview.

These attributes of course were mostly a front. That self-confidence and fearlessness crumbled to dust when the alcohol stopped working in my late 30s.

Alcoholics, as we say in AA, are chameleons. We are attracted to other drinkers, and situations where heavy drinking is normalised because it allows us to blend in, which also helps us to convince ourselves that our own drinking is fine. My success as a chameleon meant that my alcoholism went untreated until the wheels completely fell off.

Absolutely fine. Nothing to see here. *Crash, clunk.*

But, it’s not about how we fall down. It’s how we get back up again. Which is why I started this blog.

So, there you have it. As pseudonyms go, it’s a bit shit, but necessary all the same.

 

 

 

 

 

Growing up (un)gracefully

I haven’t written a Social Drinking blog post for a while because I have been going through disturbances in my personal life. This means that I needed to sort out my own emotions and thoughts about a whole bunch of things. Now I can report back, like I do in AA meetings, with new insights about my alcoholism. It has been a rough but extremely beneficial few months.

In my last post I was reflecting on, and coming to terms with, the process of separation from my wife, which was heading towards divorce. I think the gravity of what we were about to do finally sunk in when we got to see each other face to face and we finally had some conversations that we probably should have had many years ago. We have decided to press ahead, and I’m feeling much more optimistic now about our relationship.

I have also had to take stock of my own behaviour during this period of disturbance. AA has this rule that I think should sit alongside ‘don’t be an asshole’ as a solid guide to good behaviour: ‘every time we are disturbed, no matter what the cause, there is something wrong with us’. Of course, in human relationships, there probably is something wrong other people who we interact with as well. But, that is not our responsibility.

I’ll give you a tip: if you want to win friends and influence people, don’t criticise them. Don’t take other people’s moral inventory and then feel it is your right to explain to them their personal failings when you feel they have done you wrong. You might get a punch in the face. Or you might hurt someone you love. This is one of those lessons I should have learnt years ago. Instead, I’ve come late to the party of understanding.

I have also been seeing a new shrink to help me deal with some mental health issues that have never really resolved, despite years now of sobriety and antidepressants. The diagnostic finger is pointing squarely at a couple of traumatic incidents that have been giving me visual/auditory/smell/taste flashbacks and making sleep difficult for nearly 20 years. It seems I may have developed a post traumatic stress disorder. The good news is, I probably don’t need to be on the antidepressant anymore, which means byeeeeeeee to side effects 🙂

Anyway, onwards and upwards. Dance like nobody’s watching. Vacuum the house in your underpants. Run up a hill past grass-chomping kangaroos listening to Biggy’s Hypnotise. You get the drift.

FYI: relationships are hard

Getting sober is not always raindrops on roses and whiskers on kittens. Sometimes being an adult really fucking hurts.

Earlier this month, my marriage of seven years came to an end a week shy of our eighth wedding anniversary. While this was not unexpected (one cannot plumb the depths of alcoholism and addiction without it wreaking havoc on close personal relationships), my wife’s decision has knocked me off balance. However, I refuse to harbour any ill feelings towards her and am committed to ending our marriage as we started: as best friends. To achieve that goal, while staying away from alcohol, I need to Do The Next Right Thing (or DTNRT, if you like acronyms).

DTNRT

The million dollar question at this point is: How do I know if I am responding to a situation in the right way? In AA’s Step 4 we conducted ‘a searching and fearless moral inventory of ourselves’ and then admitted all our bad behaviour and character defects to another person in Step 5 (and God, if you believe in one). These steps are important because they allowed me to identify the qualities I admire in others, to reflect on my strengths and weaknesses, to identify situations and relationships that place me at risk of relapsing, and to learn when I am behaving in a way that doesn’t reflect my personal values.

When I was at a low point last week I rang someone close to me for support and, instead of finding a sympathetic ear, I received two full barrels of anger, a torrent of abusive text messages and nine missed calls while I was at work the next day. Unsurprisingly, I was angry and upset by this person’s behaviour. Fortunately I had the smarts to call my sponsor. We decided I should block the offending phone number until temperatures returned to normal, and to resume the relationship when I am on a more solid emotional footing.

Sometimes doing the next right thing is as simple as not responding to anger with anger, or attempting to find a point of agreement in an argument. At other times DTNRT is pausing when agitated or not having the final say in a conversation.

In the case of my marriage breakdown, DTNRT is about me being supportive of my wife’s decision, and to accept that she needs to grow in her own way, even if it causes ripples in my present circumstances. After all, I owe my wife my life. If making this transition in our relationship easy is what I need to do to make an amends for the harm caused by my drinking, then that is what I need to do.

No person is an island

Given the set of circumstances described above, my first instinct is to withdraw from social relationships. There is sadness there, and quite a bit of grief. That is understandable. But, if history is any lesson, I don’t fare well when I withdraw from society and attempt to do life as a solitary organism. We humans just don’t work like that.

When I was drinking and times got tough, I would dream I was marooned on an island with perfect waves and a never ending supply of rum. Instead, I found myself lying in bed at 4pm on a Tuesday afternoon with a cask of wine wondering if I had any relationships left.

The point is that, as social creatures, we need human contact.

So, instead of fleeing down the coast with a dog, a tent and a surfboard, I stuck it out this weekend and went to a bunch of AA meetings. I even went to a punk rock gig on Saturday night, drank soda water and laughed my head off with another AA member. It was good. The best thing was that I woke up Sunday morning with no regrets.

Oh, and real footy’s back. Not that thing with the round ball and the play acting. Or the other things where large men run straight at each other. No, Australian Rules! Go the mighty Cats!

Take your medicine: how a spiritual program can work for atheists

Q. How can an atheist follow a spiritual program of recovery without his or her head exploding in a puddle of existential goo? A. Start by accepting you don’t have all the answers and then fake it till you make it.

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I’ve mentioned previously that, when I first encountered the fellowship of Alcoholics Anonymous, I saw the word God scrawled across the calico banners on the wall and pretty much ran screaming into the sunset. Well, that might be a slight exaggeration, but you get the drift. Contempt prior to investigation is probably closer to the truth.

One would have thought that as an anthropologist – someone who is trained to identify their own cultural biases, and who is fascinated by the human condition in all its forms – I would have had a more open mind about this. But no, I chose to put my preconceptions ahead of sobriety and it nearly killed me. After all, I hadn’t believed in a God in more than two decades. Why start now?

I was baptised Anglican in a rural community. I went to Sunday school, youth group and was eventually confirmed as a 13 year old kid with pimples who could eat the flesh of Christ and drink his blood. It was about the same time that we were being introduced to biology at school, including the legendary story of Charles Darwin’s journey of discovery in The Beagle. Needless to say, the story of how finches evolved on remote islands seemed more plausible to me than any of the magical horseshit I was hearing or reading on Sundays. Still, the Minister had a drop-dead-gorgeous daughter, so I hung around the Church like a bad smell until I discovered beer and Saturday Nights.

Later, I nurtured resentments against ‘the Church’ for a whole swag of reasons, real or imagined: Religion is a drug that keeps populations subjugated; Christian people are duplicitous; Catholicism is institutionalised tax evasion and child abuse; etc., etc., etc. Worse still, I looked down my nose at people who believed in something spiritual and sometimes got into heated, drunken debates with Christians, armed with so-called reason and a quick, nasty wit.

Then I plunged headfirst into rehab and received my first real introduction to AAs 12 Steps, half of which appeared to exclude athiests:

  • We need a ‘Power greater than ourselves’ to cure our insanity (Step 2)
  • To get well, we have to ‘turn our will and our lives over to the care of God as we understood Him’ (Step 3)
  • After all that, we then had to admit to God all of our wrongs (Step 5), become willing to have God remove all our character defects (Step 6) and humbly ask Him to remove our shortcomings (Step 7), and
  • Practice prayer, every single day (Step 11).

Unsurprisingly, I spent most of the long hours in rehab wrestling with AA’s God concept figuring out how I could bypass the spiritual aspects of the program. While I didn’t have a religious experience, rehab did give my body and mind a chance to dry out, and my loved ones a break from having to deal with my bullshit.

It took three weeks for me to bust after rehab, which took my tally of sober days up to 60. This was the longest I had been without alcohol in my system for more than two decades. I suppose we could call that a success.

Willpower?

If you’re reading this and you don’t have a problem with alcohol, you may think that alcoholics just suffer from a lack of willpower. In response: imagine you wake in the morning after one of your best friends’ weddings in a resort town. You have spent a considerable amount of money to get and stay there, and it was a rare chance to see your old mates together again before they run off and breed. You were so excited to see everyone that you got completely carried away drinking expensive wine and can’t remember anything after the sun went down. Your partner, who will not speak to you for many hours yet, eventually informs you that you were found by the police half stumbling/half crawling down a road in an 80km/hr zone. You’d probably vow off the grog for a while, if not for life. And, you’d mean it too.

This exact situation happened to me. I vowed off grog and I meant it too. Like AA’s founder Bill Wilson, I woke up and meant business:

This had to be stopped. I saw I could not take take so much as one drink. I was through forever…

Shortly afterward I came home drunk. There had been no fight. Where had been my high resolve? I simply didn’t know. It hadn’t even come to mind. Someone had pushed a drink my way and I had taken it.

While recovering from drinking to blackout and being rescued by the police, I went out with one of my mates to get groceries. Ten minutes later I had a can of ‘Dark and Stormy’ in my hand, the first of many hangover cures consumed that afternoon.

Like Bill, my best efforts kept achieving the same result and it never took long for the wagon wheels to fall off.  For example, while I was on medical leave to ‘sort out my drinking’, I’d give my partner all my cash, credit and debit cards before she left for work. When she returned, without fail, I would be falling-down drunk.

I spoke to my best mate the other day – a prodigious and regular drinker – but not an alcoholic. He just had a month off the grog and he said it suprised him how easy it was. I was dumbfounded. I asked him if he had trouble sleeping or was irritable. He said no more than usual. I congratulated him, but not before telling him I thought he was an alien from outerspace.

We alkies have plenty of ‘willpower’, the problem is that it is directed towards drinking. Take away our wallet and access to money, we’ll still find a way to get drunk. A recent review of neurobiological advances from the brain disease model of addiction shows that addictions have not only changed our brains’ reward and decision-making centres, they have increased our reactivity to stress and given rise to negative emotions and dysphoria (researchers call this an ‘antireward system’). This means that, ‘in addition to the direct and conditioned pull toward the “rewards” of drug use, there is a correspondingly intense motivational push to escape the discomfort associated with the aftereffects of use. As a result of these changes, the person with addiction transitions from taking drugs simply to feel pleasure, or to “get high,” to taking them to obtain transient relief from dysphoria.’ So, its not a question of willpower, we just aren’t like normal folk.

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Gift of Desperation

Apparently fate had decided that I needed to become broken just enough to come back to AA with an open mind: I needed to become desperate enough to suspend my preconceptions about the program, including the fear I might get infected by some virulent strain of Godbotheryitis and turn into Ned Flanders.

In AA, we call this the Gift of Desperation (G.O.D. – see the theme here?! )

The following extracts from my journal provide a pretty good indication of my headspace before and after I arrived at my personal rock bottom. For context, the first extract from August 2014 was written by an active alcoholic who has just had a major relapse at work, and was looking to get his employer off his back by having the AOD doctor write a letter of support. The treatment plan included relying on an alcoholic self-administering a drug that causes life-threatening side effects when it is mixed with alcohol. The second extract, recorded three months later, was my first attempt to write about my rock bottom, still shaking after five days in blackout.

12/8/14

Appointment with Dr XXXXXXXXXX today. I need a plan of treatment and support and a letter to Human Resources after my last bust at work.

After appointment: plan is:

  • Six months of self-administered Antabuse (Disulfiram) 250mg daily.
  • No benzos, opioid painkillers or any other sedative style or potentially addictive drugs.
  • Regular counselling.
  • Engage with and attend AA.
  • Daily diary and journaling (i.e. this)
  • Check out SMART recovery – good for athiests?
  • Read, write and learn more about WHY I drink like I do.

Feel like a big weight is off my shoulders now that I have spoken to the doc and have the letter for work. Back in the pool swimming today!

 

5/11/14

First day sober, shaking, fearful of my own shadow, jumping at the groan of trees in the wind. Sweating buckets haven’t eaten. Lost litres of fluid in tears. Probably should hydrate.

Stopped taking Antabuse around the 31st and had a light beer but immediately had acetaldehyde reaction, got flushed, heart palpitations, etc. so backed off. Relapsed proper on the 1st and all hell broke loose. From then, piecing together events gets too hazy: at least three bottles of vodka, two boxes of cask wine…who knows what else? I didn’t turn up for work again Tuesday 4th (Melbourne Cup Day) and got my formal, final written warning from work this morning.

Somewhere in there I had a massive argument with XXXXXXXXXX and fear that relationship is over. I also seriously considered stringing up a rope in the garage, but was way too pissed to even make it that far. Fear is pretty much all I’m made of today.

I’m done.

Acceptance

Soon after I penned the above entry into my journal I walked into a meeting of Alcoholics Anonymous and haven’t had a drink since. What changed?

Quite a few things actually. I’ve written previously that I needed to own my alcoholism before I could even think to  change my maladaptive behaviours. This acceptance meant that I  walked into that meeting knowing, without a shadow of a doubt, that I am an alcoholic and that my life had become unmanageable. I knew then, as I know now, that everything good in my life could be taken away in the blink of an eye if I have another drink. This is another way of saying I had succeeded in taking AA’s first step.

Second, I did the opposite of everything I had done before when I attended meetings. Instead of sitting in the corner and not making eye contact with anyone, I shook the hand of the first person I saw and when I was asked to share, told everybody present about what a horrid fucking mess I was in, cried some tears and humbly asked for their help with snot running down my chin. I walked out with a bunch of phone numbers and got a sponsor shortly after.

Third, when people said I didn’t have to believe in any Gods or Goddesses to succeed in the fellowship, I listened to them. I asked them how they interpreted AA’s steps to make meaningful changes in their lives and did what they suggested.

Fourth, I kept going back to AA meetings. I learned to appreciate Nestle Blend 43 freeze dried coffee and Arnott’s Assorted biscuits, and realised that the more I listened to other people’s stories, the less I spent worrying about having another drink or losing my job. In the process of doing this, I stopped isolating and became a human being again. Time, as they say, is a great healer.

Lastly, I learned to meditate and *gasp* pray. Not the ‘Sky Daddy strike down my opponents so I can win the tennis tournament’ type of prayer. No, these prayers are all about forcing a change in perpective in me. If I’m feeling resentful at someone, it was suggested to me that I ‘pray’ for them: visualise all the good things that I would wish for myself, and then project those feelings onto the other person – e.g. that miserable, stinking bastard who cut me off in traffic. If I do this for long enough, sometimes through gritted teeth, the feelings of anger and resentment slip away.

Final word

Australia is a proud, successful multicultural society whose religious beliefs have become more diverse over the past 50 years. While half of Australians identify as Christian, other faiths like Hinduism, Sikhism, Islam, and Buddhism all increasingly common religious beliefs. The Australian Bureau of Statistics reports that, in 1966, Christianity (88 per cent) was the clearly the main religion. By 1991, this figure had fallen to 74 per cent, and then to 52 per cent in 2016. Catholicism is still the largest Christian grouping in Australia, accounting for almost a quarter (22.6 per cent) of the Australian population. Those reporting no religion was higher than the number of Catholics in 2016 at 30 per cent.

The fact that there are now more atheists than Catholics in Australia is notable, reflecting a trend that has been happening for decades. Those reporting no religion increased from 19 per cent in 2006 to 30 per cent in 2016.

It is within this context that a number of secular, athiest, agnostic, humanist, and freethinker AA meetings have sprung up in the eastern cities, offering hope to people like me who use their athiesm as another excuse to keep drinking. This is a welcome development in Australia and elsewhere that shows that the fellowship is being responsive to Australia’s changing community, in line with it’s first tradition that ‘the only requirement for membership is a desire to stop drinking’.

 

 

AA member survey

AA estimates that it has between 18,000 and 20,000 members and about 1,800 Groups in Australia. AA doesn’t keep records of its members or formal statistics of its membership; however it does conduct surveys from time to time. These surveys provide a picture of how AA is performing, and how it can improve.

Recently I reviewed Dr Joseph Nowinski’s popular science book If You Work It, It Works! The Science Behind 12 Step Recovery (2015). One of the book’s primary sources of data was periodic AA member surveys from the United States, including the years 1977 to 1989, 2007 and 2011.

This data is important because it shows how AA has changed in the United States since 1977. For example, women’s participation has increased to one third, while people reporting drug addiction in addition to alcoholism has increased from 20 percent in 1977 to nearly half in 1989. One of the interesting things Nowinski found was that AA’s method and message has remained remarkably consistent: if you want to get sober go to meetings, join a home group and get a sponsor.

In Australia, the most recent AA member survey was conducted in 2006, which is a bit rubbish really. Prior to this, the surveys were conducted every four years. The results will be published in November, so expect a full wrap-up and some preliminary analysis here on socialdrinking.blog just in time for the silly season.

If you are an AA member in Australia, get your response in quick as the survey closes at the end of March!

Details as follows:

Australian Fellowship Survey

The Australian General Service Conference 2017 has asked that this survey be extended to March 30th, 2018.

Please pass this message on to your AA contacts, who may not have participated in this initiative, and to pass this message on to their own AA contacts.

The survey can be found and completed at: https://www.surveymonkey.com/r/S26J52S

Notes on a meeting

A couple of guys in white collared shirts are having a laugh and a cigarette on the footpath, the adjacent building casting cool shadows in the early evening summer sun. I walk up, make some small talk and ask how their day is going. I’ve long since quit tobacco, so I don’t linger and head inside.

The group meets for one hour each week in a small room at the back of a local-government administered community facility. There are three core members of the group who have taken on the responsibility of keeping the doors open each week. This requires a number of tasks to be completed, including picking up the keys and opening up, welcoming newcomers and visitors, chairing the meeting, bringing and setting up the tea, coffee, biscuits, literature, collecting donations, putting out the chairs and, later, packing up.

People who attend the meetings always help out where they can, for example washing up coffee cups and stacking chairs. In the old days, the ashtrays had to be emptied too. These are what we call in AA ‘esteemable acts’: actions that build one’s self confidence and self-esteem through being useful to other human beings. Esteemable acts also include smiling and showing interest in other people, rather than ignoring them.

AA understands that when we value ourselves, we are less likely to drink or to behave in ways that are unhealthy to ourselves and others. In short: doing esteemable acts, like saying g’day to someone new and offering to make them a cuppa, helps us stay well. So, that’s what I do.

How do you take it?

White with one thanks.

Biscuit?

Members drift in and out of groups. Sometimes, there are more members of this group than there are service jobs to fill. At other times, such as now, there is little redundancy and therefore more responsibility is needed to be taken on by the three members. In practice, these are simple tasks. But the important thing is that they get done, by someone.

There are other members of the group who have drifted away. Some may have drunk again. Some may have moved to another town, or just to the other side of this one. Some may have even got the shits and developed a resentment against the group. It happens.

It is an open meeting, which means that anyone is welcome to come along and listen. However, only those people who identify as an alcoholic are called on to share. As the group is self-supporting in line with AA’s traditions, only those who identify as alcoholics are asked to give coin donations at the end of the meeting. If a friend or family member comes along in support of a newcomer, for example, it is considered inappropriate for them to contribute a coin to the basket at the close of the meeting.

Usually, no more than 15 people attend this particular meeting, which means that everyone gets a chance to share for a few minutes (going on for more than 5 minutes in a full room is considered poor form).

Some groups take a tougher line than others on asking addicts to share, although most of the addicts that come to this meeting identify primarily as alcoholics and are always called on to share.

We start with introductions, sitting in a circle.

The famous ‘hello I’m … and I’m an alcoholic’.

Some add their length of sobriety in years or months or days. Others mention where their home group is located and when.

This particular meeting starts with a reading from AA literature and then members get to riff on the topic or to share their experience, strength and hope in recovery. Usually it’s a bit of both.

Once everyone has had a chance to share, the meeting is closed with a reminder of AA’s principle of anonymity. The basket is passed and each person throws in a few coins, some gold.

We join hands, as the embodiment of strength in unity, and recite the serenity prayer.*

There are some announcements, including one about an upcoming camping weekend away. Coffee cups are washed, chairs are stacked. Hands are shaken, hugs given, laughs had. Phone numbers are exchanged. Some friends head off for another coffee.

The shadows have lengthened as the butane flames lick paper and tobacco.

I leave feeling better than before. More level. The right size. Just for today.

* ‘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.’ Personally, I prefer meetings that close with the secular Responsibility Pledge: ‘I am responsible. When anyone, anywhere reaches out for help, I want the hand of A.A. always to be there. And for that, I am responsible.’

Book review: the science behind 12 Step recovery

Nowinski’s excellent popular science book If You Work It, It Works! The Science Behind 12 Step Recovery (2015) makes it pretty clear: AA only works if you participate.

Dr Joseph Nowinski’s name came up a bunch of times when I was doing research into international best practice in treatment and support for alcoholics and risky drinkers.  I was completing this work at the same time my drinking was at its white-spirit-worst and, because of that, I nearly lost the job for good.

In fact I’m pretty sure Nowinski’s Twelve Step Facilitation Therapy Manual: A Clinical Research Guide for Therapists Treating Individuals With Alcohol Abuse and Dependence(1999) was even on the shelf when I was poking around in the literature cupboard at my last rehab. By that stage I had decided AA was definitely some kind of cult. Why else would people willingly go out of their way to help perfect strangers? Surely they had some other motive?

It turns out they did have an alterior motive. But they weren’t trying to sell me salvation proportionate to my income. No, helping others made them feel better.

Nowinski

Project MATCH :/

Dr Nowinski contributed to Project MATCH (1989-97), the largest alcohol treatment trial ever conducted involving 1726 alcohol dependent volunteers over several treatment sites in the US. The aim of Project MATCH was to find out if different types of ‘alcohol abusing or dependent patients’ respond differently to the most widely used treatments for alcohol dependency: Cognitive Behavioral Therapy (CBT), Motivation Enhancement Therapy (MET) or Twelve-Step Facilitation (therapists introduce patients to AA, explain some of the concepts and get them to attend meetings. The focus is on AA’s steps one to five).

Project Match’s data dissapointed a lot of people in the addiction and recovery field. It reinforced what many suspected: that matching the right treatment to individual alcoholics is difficult, and that treatment outcomes are similarly dissapointing across the board. In other words, Project Match didn’t offer a silver bullet for treating alcoholism.

Yet, the fact that a treatment protocol based on AA’s 12-steps – an unscientific, quasi-religious oddity – could achieve similar results as CBT and MET was notable, given that AA costs nothing to taxpayers and provides critical post-intervention (e.g. hospital E.R., detox, rehab) support in the community.

AA only works for those who take action

The title of If You Work It, It Works! is intentional because, as Nowinski points out, only half of us who attend AA stay active in the fellowship after three months.

I recently lost 20kg because I changed my diet and started running. Thinking about it didn’t get me healthy.

Nowinski analysed AA member surveys to find out what actions people take in AA to stay sober and found attending at least two and preferably three meetings a week, joining a home group, and getting a sponsor were the top three responses. These same three actions kept me sober in my early days of sobriety.

Nowinski examined a range of research on AA attendance and involvement, and treatments that encourage AA attendance. The results show that:

  • Getting into some form of counseling and starting AA at the same time is a winning combination if you want to stay sober.
  • Getting involved in the AA Twelve Step fellowship leads to superior results than simply attending meetings.
  • Identifying yourself as an AA member makes a positive difference.
  • Therapy that actively facilitates AA involvement is superior to treatment that does not include this focus.

He also notes that there is a spectrum of alcoholism and problem drinking and that, for some, controlled drinking may have its place after a period of conditional abstinence.  For those like me, who have tried and failed at controlled drinking and have ridden the ‘just one’, drink-drank-drunk *crash*, remorse cycle so many times the very idea of controlled drinking is laughable, Nowinski says that abstinence should be ‘the most appropriate goal’.

How it works

1. Social networks

Like me, Nowinski attributes much of AA’s value to the relationship between social networks and recovery. He uses a number of published studies to show how both involvement in AA, and the people in an alkie’s regular social network, are critical to long-term recovery. AA involvement seems to act as a buffer, particularly where a person’s regular social network includes frequent or heavy drinkers. Some people use AA as an alternative social network, particularly when there is always drink at home. I’m lucky that my immediate family are not huge drinkers and my best mates, while still capable of epic feats of party mayhem, are generally pretty sensible and respectful of my non-drinker status.

Interestingly, problem drinkers in a person’s social network exert a more powerful and negative influence on recovery than non-drinkers. In other words, surround yourself with drunks and you’ll probably end up just that – drunk. Surround yourself (at least some of the time) with AA members and you’ll probably stay sober. Dead simple.

2. Spirituality and sponsorship

As a scientist, Nowinski doesn’t engage in spiritual or theological argument. Instead, he presents published studies that have examined the role of spirituality in recovery. Obviously there are limitations in this data because concepts like spirituality are open to interpretation – particularly by sick people responding to surveys. The studies show that greater involvement in AA leads people to become ‘more spiritual’ over time, which is, in turn, positively associated with sobriety. This is not suprising, since AA is a program that emphasises the benefits of spirituality, particularly prayer and meditation.

The other aspect of AA’s spirituality Nowinski finds beneficial is the focus on personal values and self-reflection. He concludes that ‘spirituality, as it is reflected in AA’s emphasis on honesty, humility, and personal renewal, as opposed to formal religious observance, may be the key dynamic responsible for this change’ (p.148).

Nowinski’s message is clear: AA spirituality is not about joining a cult or a church. It’s about ‘pursuing a life of meaning and values. These include honesty, the courage to admit to shortcomings, humility, and altruism. Within the AA culture these values are demonstrated through action’ (p. 160).

Studies on sponsorship are pretty unequivocal: getting a sponsor early greatly increases your chance of not drinking again. However, this effect seems to decrease with time. Nowinski says that the adage ‘better late than never’ probably applies here, and I have to agree with him.

3. Neurological factors

Alcohol kills brain cells. That bit we knew already. But, if you drink like I did, it also greatly increases your chance of suffering from depression and/or anxiety, as well as PTSD and schizophrenia. The point is that most alkies seem to have some sort of psychiatric comorbidity or dual-diagnosis to party with their alcoholism and other addictions.

Nowinski reviews the evidence on recovery for alcoholics with dual-diagnosis and finds that, as long as people work their AA program, these illnesses ‘do not appear to consitute a major barrier to recovery’ (p. 181).  He concludes that recovery (and particularly Twelve Step recovery) has healing powers of its own.

Is it worth reading?

In a word, yes. Nowinski’s book is:

  • a much needed kick in the pants for alcoholics like me who forget to put in the action each day. Treatments for diabetes and heart disease are never effective 100 percent of the time, because they are dependent on whether or not a patient follows the treatment recommended by their doctor. As Nowinski puts it: ‘the best we can say, then, is that these treatements are likely to work if the individual works them’; and,
  • an excellent introduction to the medical literature on alcoholism and recovery, which shows that AA has some good, recent scientific studies supporting its approach to recovery.

Working with others

Alcoholism is a chronic, relapsing condition that, if left untreated, can be fatal. The main treatment I and millions of others around the world find effective is to work with fellow alkies and follow a few very simple principles based on honesty and respect for others. But, for me, it’s primarily about a unique human connection – one that is based on empathy. Or, as the old timers say, ‘the magic happens when one alcoholic works with another alcoholic’.

A great example of this is found in the AA Big Book in chapter 11 (pp.156-8). The story refers to Bill and Bob’s first visit to a guy who would become AA’s third member; a visit that resulted in AA’s first group at Akron, Ohio in 1935.

Bill W and Dr Bob had only just figured out that they needed to ‘keep spiritually active’ by working with other alcoholics, so they called up a local hospital and spoke to the head nurse:

They explained their need and inquired if she had a first class alcoholic prospect.

She replied “Yes, we’ve got a corker. He’s just beaten up a couple of nurses. Goes off his head completely when he’s drinking. But he’s a grand chap when he’s sober, though he’s been in here eight times in the last six months. Understand he was once a well-known lawyer in town, but just now we’ve got him strapped down tight.”

…Two days later, a future fellow of Alcoholics Anonymous stared glassily at the strangers beside his bed. “Who are you fellows, and why this private room? I was always in a ward before.”

Said one of the visitors, “We’re giving you a treatment for alcoholism.”

Hopelessness was written large on the man’s face as he replied, “Oh, but that’s no use. Nothing would fix me. I’m a goner. The last three times, I got drunk on the way home from here. I’m afraid to go out the door. I can’t understand it.”

For an hour, the two friends told him about their drinking experiences. Over and over, he would say: “That’s me. That’s me. I drink like that.”

The man in the bed was told of the acute poisoning from which he suffered, how it deteriorates the body of an alcoholic and warps his mind. There was much talk about the mental state preceding the first drink.

“Yes, that’s me,” said the sick man, “the very image. You fellows know your stuff all right, but I don’t see what good it’ll do. You fellows are somebody. I was once, but I’m a nobody now. From what you tell me, I know more than ever I can’t stop” At this both the visitors burst into a laugh. Said the future Anonymous: ‘Damn little to laugh about that I can see.”

The two friends spoke of their spiritual experience and told him about the course of action they carried out.

He interrupted: “I used to be strong for the church, but that won’t fix it. I’ve prayed to God on hangover mornings and sworn that I’d never touch another drop but by nine o’clock I’d be boiled as an owl.”

Next day found the prospect more receptive. He had been thinking it over. “Maybe you’re right,” he said. “God ought to be able to do anything.” Then he added, “He sure didn’t do much for me when I was trying to fight this booze racket alone.”

Bill and Bob continued to work with the man, and after three days he had become ‘willing to do anything necessary’, including to give his life to the ‘care and direction of his Creator’.

That afternoon he put on his clothes and walked from the hospital a free man…He never drank again. He too, has become a respected and useful member of his community.

Eight decades have passed since two alkies working together became three, then four, and now millions worldwide. And yet, the story remains relevant.

Aside from my wish to resurrect the phrase ‘as drunk as a boiled owl’, this is one of my favourite sections of the Big Book because it provides hope to those of us who are still suffering and can see no way out.

Most of the people I know in AA who have been to a rehab or detox have also drunk either on the way home from their treatment, or soon after. Just like our formerly-respected-lawyer-Anonymous #3. I did too, on two separate occasions. When we discuss these events we speak of unnatural, sanitised environments that do not prepare us for life after our time in confinement is up, certainly not if we return to our communities with no lifelines (I have many AA members’ numbers in my phone who I can call on at any time). This phenomenon – the relapsing nature of the condition – continues to challenge the medical profession and policy-makers alike.

But, for eight decades, AA has been keeping people sober on little more than a pay-it-forward faith in something more powerful than the individual.

The Big Book likes to call this something God. Today, AA teaches that it just has to be something other than ourselves. Even the AA group – a thoroughly humanistic Higher Power if ever there was one – can be this special something.

But, most of us have found that we can’t just rely on gods and goddesses to get us well. We have to put in some work too.