• H&R Moderators: VerbalTruist | cdin | Lil'LinaptkSix

A rant about current treatment models

Yeah. A lot of group B on bluelight I would guess. I'd love to try out SMART recovery but the only meetings I know of clash with work. It just seems like a more logical, structured approach.
 
I'm thinking I'll give this IOP a week (3 sessions) since group membership is not consistent session to session. Unless I find the therapist that runs it really lacking in some way.

I'm definitely group B. My issues with 12 step recovery are numerous:

1. Belief in a supernatural power that can cure you of addiction
2. Dismissal of modern treatment techniques such as medication and psychotherapy
3. Attitudes toward the newly sober that are at best are patronizing, at worst abusive in a way that to me resembles college fraternity hazing
4. Judgement that often encourages relapsers to be less than honest about it; relapse/failure is the addict's fault alone
5. Datedness - this applies more to AA than NA as I have both books, but I have an issue especially with the sexism in The Big Book. Exhibit A: the "To the Wives" chapter
6. Cliquishness - let's face it, these people overall are just not very nice

I'm sure I can think of more. I would try a SMART meeting but in my area there are only two meetings a month and it probably a 30 mile drive one way. I live in northwest Orlando and the SMART meetings are in a far eastern suburb. I'll probably start rereading Rational Recovery for some inspiration.
 
AA/NA do remind me of high school a bit in the social aspects. But shit that's just how humans interact You cant change a hundred thousand years of evolution in a self help group for drug addicts. If it helps you go if it doesn't don't go sometimes we think we are making huge unalterable decisions when we are really just doing what normal people do everyday. make decisions. When we are using the drug makes most of the decisions for us it tells us where to go what to do who to hang out with ect. When that suddenly all stops its a bit scary to start making decisions based on what you want to do. Its scary but that's life the longer your not letting the drug make the decisions the more options will open up. My point is don't stress the small shit
 
My perhaps biggest frustration with it is the attitude that one cannot get/stay clean without the Steps and the song/dance that comes with them. This is complete and total rubbish, and it feels eerily similar to religious groups telling people that they won't go to heaven without converting. That attempt to disempower the newcomer and immediately make him obedient to the group, propped up as his only salvation, is what makes it most creepy.
 
As a secular Jew, I think the overtly Christian overtones (esp closing meetings with the Lord's Prayer) is what turns me off most to AA; NA not so much, but NA has other issues such as the lack of long term sobriety among its membership and the often overt sales of drugs on meeting premises. I'm not even totally dismissive of the concept of a higher power, because with all the shit I've done, it really is miraculous that 1. I never got a DUI, 2. I never injured/maimed myself or another person, 3. I am not in prison, and 4. I am not dead. However, I do not like quizzed/needled about my religious convictions (or lack thereof). If I wanted to take part in organized religion, I would. I do not believe that recovery and a lack of religious convictions are mutually exclusive.

EDIT: I should state that I am not dismissing 12 step out of hand. I've been through the steps multiple times and did my damnedest to try and make the program work for me for 4+ years. But finally I could not dismiss the fact that I had serious problems with the fundamental ideas of 12 step recovery.
 
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I am always happy to hear from people who are able to get past all the shit I can't seem to tolerate about twelve step meetings and benefit from them, like the way you and [mention]simco[/mention] have been. Dare I say, sometimes I even feel a bit envious, but then again I do love what I have found for myself :)

I do believe that involvement with NA (I can't speak for AA since I've never attended) CAN be a great supplement to addiction recovery. But I do always feel compelled to qualify that endorsement a bit. I don't believe that NA is a good fit for everyone. And even those who do benefit from it--I believe--are best served if they retain their own agency, their own autonomy with respect to recovery. In other words: take what you need and leave the rest. The tricky part is figuring out which parts you need! ;)
 
I do believe that involvement with NA (I can't speak for AA since I've never attended) CAN be a great supplement to addiction recovery. But I do always feel compelled to qualify that endorsement a bit. I don't believe that NA is a good fit for everyone. And even those who do benefit from it--I believe--are best served if they retain their own agency, their own autonomy with respect to recovery. In other words: take what you need and leave the rest. The tricky part is figuring out which parts you need! ;)

Both programs have their pros and cons (of course this is just my opinion based on my experience with both programs):

NA
Pros: less overtly religious IME; literature is more up to date
Cons: general lack of long-term sobriety among its membership; at times drugs are being sold on meeting premises and it's not even discreet

AA
Pros: much greater number of people with long-term sobriety compared to NA
Cons: many meetings are overtly religious and Christian at that; The Big Book is woefully out of date for 21st century society

I ended my involvement with 12 step after really lousy sponsor experiences in both programs. My NA sponsor constantly berated me for taking psychiatric medications and told me that until I stopped, I couldn't consider myself sober. He actually stopped me from getting a 30 day keytag for that reason. I then switched to AA (my primary DOC was alcohol anyway, opiates/opioids were an afterthought most of the time). I started out with a good relationship with my sponsor, but then he started calling at random times wanting to do step work, and if I wasn't available or said no, I would get berated for not working the program and be accused of not really wanting to be sober. I landed in a detox last March and the therapy there was not 12 step based. I was taught how to find support outside 12 step and honestly, the pdoc there prescribing me Celexa changed a lot. Having a sense of well-being greatly lessened my need to use a substance to tune out life. This is not meant to be a condemnation of 12 step. I know it helps a lot of people, it's just not something that worked for me.
 
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@aihfl, I had a really terrible sponsor situation in NA as well...very much along the lines of what you describe. It left such a bad taste in my mouth that I avoided 12-step groups for over a year. When I did finally return to NA, about four months ago, it was out of desperation...I was in a bad way and needed to alleviate my pervasive feelings of alienation and loneliness. The fellowship has really helped with those particular problems. But my earlier experiences have made me very cagey about NA.

In case it helps other people, here are a few ways I've crafted my relationship with the group, to assure that it's therapeutic for me. Repeat...these are simply my own strategies. Your mileage will surely vary!

Things I do:
  • I attend meetings regularly but not too often (approx 3 meetings weekly). This helps me feel connected, while helping me avoid burnout.
  • At meetings, I do very small kinds of service. I make coffee; I clean up afterwards; stuff like that.
  • I maintain boundaries. For example, I don't meet up with NA folks outside of meetings unless it's for a legit event.
  • I try to talk on the phone or by text with a few trusted NA acquaintances more than I would normally choose to. This is one of the best antidotes for loneliness after/during addiction that I've found. I don't like doing it very much (awkward). But doing it even if I don't feel like I "need" it at the moment really seems to help. N.B. These calls are to people I've gotten to know fairly well, and who have demonstrated commitment to getting better.
  • Read the literature. Sometimes the NA literature is pretty bad. But again, it does help me feel connected.
  • I consider and meditate on step-work. But without a sponsor (see below), formal step-work isn't really viable.

Things I don't do:
  • I don't have a sponsor. I'm really conflicted on this one. I know it's a crucial part of the program, but my previous experience has made it hard to seek out that relationship. Maybe some day I'll get a sponsor. But for now, that's not part of my deal.
  • I don't give my phone number out in general. I'll give it to someone I've gotten to know. But I don't write it down for anyone to grab. I learned this the hard way after a guy started calling me wanting to cop/use, etc.
  • I don't seek complete abstinence from drugs. I still use cannabis plenty. But I'm deadly serious about putting heroin behind me. (Luckily alcohol and most other drugs were never very alluring for me...easy to skip.)
  • I don't let bullshit alienate me from the group. People say some stupid shit at meetings (and in the literature). Denigrating psych meds, ORT, non-NA recovery, etc...all that will drive me crazy, and drive me away from the group if I let it. I use the serenity prayer to get past moments when this kind of thing comes up ;). If someone says something really egregious, though, I will argue--otherwise my conscience feels violated.

Most NA members who read this list would rightly complain that I'm not "working the program" at all. And I don't dispute that. NA is a *part* of my toolkit for recovery. I use it to mitigate feelings of isolation related to drug use (and abstinence). Over time, maybe my relationship with the group will mature. I'd honestly like it if I could find someone I trust enough to seek out as a sponsor. But meanwhile, this very limited involvement seems to help.

As always, I encourage folks to tread cautiously in the land of 12-step recovery. But I also encourage folks who are even a little interested to consider giving it a chance, keeping in mind that you always need to keep your head with you when it comes to recovery.
 
During that detox in March, we had to watch a video of an AA speaker who spoke at length about how the original values of AA (probably applicable to NA as well) have been warped over time by "old-timers" in the program today. The way I've been talked to by many "old-timers" especially in AA is about the furthest thing from the accounts of the outreach work done by Bill Wilson and Dr. Bob. In working with my therapist, I've learned to just not have anything to do with people that bring me down, as that becomes an excuse to drink or use. I walked away from my first career as a symphony orchestra musician and college music professor for that reason (still work in the education sector).
 
pervasive feelings of alienation and loneliness.

That's really the only appealing aspect of AA/NA, I think. The fact that it provides a community of people with comparable life experiences & (presumably) goals...it's especially relevant considering how isolating it can be when you have a substance use disorder.

I don't agree with the ideology or worldview of the group, though. I don't plan on going down that route again. To me attending AA/NA but disagreeing with them on everything & not getting a sponsor/"working the steps" is like attending church but telling everyone who'll listen that you don't believe in god. At first people will nod understandingly but slowly the attitude of "well what the fuck are you doing here then?" creeps in...
 
That's really the only appealing aspect of AA/NA, I think. The fact that it provides a community of people with comparable life experiences & (presumably) goals...it's especially relevant considering how isolating it can be when you have a substance use disorder.

I don't agree with the ideology or worldview of the group, though. I don't plan on going down that route again. To me attending AA/NA but disagreeing with them on everything & not getting a sponsor/"working the steps" is like attending church but telling everyone who'll listen that you don't believe in god. At first people will nod understandingly but slowly the attitude of "well what the fuck are you doing here then?" creeps in...

While I do agree with you, particularly that the individually isolating aspect of addiction can be very damaging to one's wellbeing, I often tend to find people just as isolated as a group in abstinence only NA/AA type communities. I mean, isolated from ways of though that aren't part of their collective groupthink.

It's kind of like the notion of how you can find yourself surrounding by people and feel just as isolated and alienated as you did when you were all alone. It goes back to [mention]RedLeader[/mention]'s comment earlier about how he has noticed two types of people in recovery: those who started using more to fit in with a certain group and found themselves caught up with the use itself, and those who started using more to treat some sort of deep existential crisis. The former seem to benefit from the socializing aspect of AA/NA type groups and the latter benefit more distinctive, individualized care.

Also see: http://www.bluelight.org/vb/threads...ello-2017!?p=13931737&viewfull=1#post13931737
 
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I often tend to find people just as isolated as a group in abstinence only NA/AA type communities. I mean, isolated from ways of though that aren't part of their collective groupthink.
This is an excellent point. If one is working 40 hours a week, even going to a meeting every day, let alone multiple meetings, does not leave you a whole hell of a lot of time to enjoy your hobbies. The therapist at the IOP I attended in 2014 told me, "You should practically be living at AA." In hindsight, no, I shouldn't be. I should be out on my bike, in my kayak or on my paddleboard or sailboat with friends who enjoy the same activities. I was getting to the point where the only people I had regular communication with was with people in AA, and the people in my homegroup were constantly meeting outside meetings socially. Do I want a group of drunks and addicts as my closest friends? Ultimately I said no.
 
It's also just an introversion/extroversion thing. Those two terms are supposed to be used to how one finds ones source of energy, how one wants to ground oneself, rejuvenate oneself and so on. Introverts find that within themselves, and that connection to the deeper self is often drawn out by solitary activities like meditation, exercise or being in nature. Extroverts find that outside of themselves and often within the communication and socialization of groups of people. These people sometimes feel uncomfortable being alone and the spice of life to them is human interaction. I think that AA/NA caters to extroverts and offers them that energy source and spiritual rejuvenation, but the exact same experience may just leave an introvert feeling anxious and uncomfortable (like the extrovert having to be alone). And it's a stubborn human trait for people to assume that what works for them should work for others as well, so people at meetings may look at the introvert newcomer and assume it's only a matter of s/he not putting in the effort to make things work.
 
Whoa, there, fellas... I'm starting to sense some pretty major generalizations in this thread. Of course it's fine to rant about AA/NA. The fellowships have brought disdain on themselves through the kind of bad behavior witnessed in several of the posts on this thread. But I think it's reductive to assert that extroverts do well in AA/NA, while introverts are stifled by it. Likewise, I don't believe that it's generally true that people who used drugs to cope with problematic emotions (as opposed to people who used drugs as social lubricant) find AA/NA unsatisfying. Lastly, I think the choice between participating in AA/NA vs. taking part in healthy hobbies is a false choice...there's no reason at all that a person can't choose 'all of the above.'

I count myself as a very introverted person. Likewise, my own drug use has always been closely linked with self-medicating my depression; I almost never used with other people. And in many ways, it's these exact qualities that have led me to attend NA despite my disagreements with much of its dogma. NA is one of the few places I go where:
  • I can sit quietly with other people, listening to those who care to share. i.e. Silence/introversion are perfectly acceptable in NA meetings.
  • I can push my boundaries by sharing occasionally, knowing that if I throw up my hands and say, 'I honestly have no idea what I'm trying to say,' people will still respect me for contributing, in however limited a way.
  • I hear stories that remind me that in my isolation and introversion, and in my efforts to blot out depression, I'm not alone.
Admittedly, these data come from a sample with N=1 (me). But it is the case that the people I've become close to in NA are, for the most part, similar to me in many emotional ways.

None of this discounts the many real drawbacks of 12-step fellowships. But it really rings false to me to argue that AA/NA is effective only for certain classes of addicted people. That's needlessly divisive, not obviously true, and it comes dangerously close to the common argument that AA/NA are best suited for not-very-smart people.

Again, there are PLENTY of totally legit reasons to criticize AA/NA. But I don't believe that personality type has much real impact on an individual's experience with these groups. Likewise, there's truth to the risk of groupthink in AA/NA, and concomitant risks of isolation within a 12-step community. But these risks are matters of how individuals choose to interact with the groups. As always, it's my contention that a genuinely therapeutic engagement with AA/NA demands setting boundaries between the group and the individual, and maintaining a critical eye in one's relationship to the group. However, the need to own and guard one's own recovery extends to ANY intervention, not just 12-step fellowships.
 
Awesome post sim! Love the critical thinking I get to enjoy through my peers on BL :)

I tend to agree that the group based recovery programs like meetings do cater a bit more to people who, well, enjoy being in groups. I think what you're pointing out is that the twelve step community, while a bit lopsided to the group setting, is about more than just spending time with other steppers. There is literature, sponsorship work, etc, that has more an individualistic focus.

I find that 12 step culture pushes meetings really hard, as it is such a core emphasis of the program - above step work, literature and sponsorship/service work. BUT, that does in no way mean that folks who find they benefit more from the individual focus can devote their energy to such things.

When it comes to the mindfulness work I do, the emphasis is on going within on's self. The practice really centers on the cushion, and meditating is a fairly internal process. AA and NA on the other hand put the emphasis a bit more towards meetings, showing up and fellowshipping with peers in the program.

I don't think it is unfair to say that 12 step communities draw more from extroverted values where as the mindfulness stuff I do draws more from introverted values. It isn't a judgement, just an observation in my eyes.
 
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First of all, I've disclaimed in all my posts regarding 12 step that I am simply stating my opinion, based on my experience, which hasn't been good.

simco said:
Lastly, I think the choice between participating in AA/NA vs. taking part in healthy hobbies is a false choice...there's no reason at all that a person can't choose 'all of the above.'
Not IME. A good many of my friends that I sail, kayak, cycle etc. with are social drinkers. I got really sick of hearing at meetings, and from that hack IOP therapist two and a half years ago stupid platitudes like, "If you go to a barber shop, sooner or later you're going to get your hair cut." I did just about all my drinking alone and in secret and honestly, I'm less inclined to drink around friends, even if they're drinking, because I don't want to take the chance that I am going to make an ass out of myself. That quote from the therapist, "You should practically be living at AA," and the demands that both sponsors put upon me were untenable. I don't want my life to revolve around recovery. I want my life to revolve around life, and if it does, then recovery just comes naturally. It did for 10 months anyway. I was put in a position where I HAD to choose between having a life or having my life revolve around 12 step, and I chose the former. Having a life turned out to be the best "program" of all. And by further extension, I can't agree with the implication that my entire world should only revolve around people in recovery through 12 step (reference the therapist's quote again) because there's a lot of people in 12 step that may be abstinent, but they're FAR from sober and their behavior in many cases they're just as antisocial as when they were drinking or using.

simco said:
  • I can push my boundaries by sharing occasionally, knowing that if I throw up my hands and say, 'I honestly have no idea what I'm trying to say,' people will still respect me for contributing, in however limited a way.
I have rarely been treated respectfully at 12 step meetings, especially by "old timers." I've had old-timers rudely make snide comments while I was trying to share (these people are such bullies that no one will enforce the no crosstalk rule), I've been told I'll never be sober, and I've been told I have no right to even share. Reference what I said above about antisocial behavior.

Finally, I need to add, this is not a generalization made by just going to a handful of meetings. I tried my damnedest to make 12 step work for me (I've been through the steps multiple times with sponsors) and I tried at least 30 different meetings over the span of 4-5 years, both NA and AA, in Greater Orlando. And I found the people for the most part repellent at each and every one. I'm not trying to convince anyone 12 step sucks, I am just voicing that 12 step sucked for me, and if it sucks for you, 12 step does not have a monopoly on sobriety.
 
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I tend to think/talk in terms of trends (not absolute claims), but maybe I should be more clear about this.
 
I've been to two IOP meetings so far this week. Had I made a decision based on yesterday's group, I wouldn't have gone back. Everyone except me was court ordered. It started late and ended early, there was no structure, and it just seemed like babysitting. Today was a little bit better; the therapist had everyone go around the room and talk about why they were there. Again, everyone else was either court ordered or mandated to attend by their employer. It was slightly more productive than yesterday but still, I am going voluntarily because I want to reinforce my skills to fight off the fuckits and I'm not getting it. I'll give it maybe 1-2 more chances before I write it off. I know what I need to do to stay sober, but I could use help for the times I'm struggling with the decision not to pick up or not.
 
I've been to two IOP meetings so far this week. Had I made a decision based on yesterday's group, I wouldn't have gone back. Everyone except me was court ordered. It started late and ended early, there was no structure, and it just seemed like babysitting. Today was a little bit better; the therapist had everyone go around the room and talk about why they were there. Again, everyone else was either court ordered or mandated to attend by their employer. It was slightly more productive than yesterday but still, I am going voluntarily because I want to reinforce my skills to fight off the fuckits and I'm not getting it. I'll give it maybe 1-2 more chances before I write it off. I know what I need to do to stay sober, but I could use help for the times I'm struggling with the decision not to pick up or not.

Perhaps a different IOP could be found?
 
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