SteveH

"12-Steps" - What is your opinion/critique?

39 posts in this topic

My personal experience is that even recovering from a psychosis (I was once a schizophrenic, or at least diagnosed as one) is largely a question of volition. If I had not *chosen* to put forth a peristent effort to think, for example in order to read magazines and books, I might very well still today, roughly 35 years after my psychosis, still be lost in the daydream world of the fantasies that I lived in when I was schizophrenic. And also, I would not have discovered Objectivism.

However, to be fair, I have to say that volition was probably not enough for me to be able to recover from my psychosis. I doubt that my mind would have "calmed down" enough for me to be *able* to choose to think for protracted time intervals, without the help of chlorpromazine (a classic anti-psychotic drug which I took regularly until 3 years ago, when another drug was substituted for it).

I think this is key, Henrik. I have had both a close relative and 2 close personal friends (ok, 1 a spouse) who had an alcohol drinking problem and went to AA to solve it. I attended several meetings to support them, and read the books, so I know what went on there. In 2 of the 3 cases, it had a strongly beneficial effect, in the short term. And I mean that 'short-term' pointedly. The intent of AA is to teach that you are an alcoholic for life and that you will need to be an active member of AA for life to cope with it.

As a former biologist by training, I acknowledge that the use of alcohol and certain drugs may make persistent changes in body chemistry and receptors that condition the brain and that may make a former abuser, an 'addict', quickly susceptible to a relapse and that such a person needs to be careful. Hence the idea in AA that 'once an alcoholic, forever an alcoholic'. But I agree with Thoyd Loki and Henrik Unné that volition has a lot to do with recovery and everything to do with a true and complete psychological recovery. And, in a very related sense, I agree with Henrik that one may have to find some 'crutch', some help, to reduce the debilitating symptoms to a manageable point, so that you can think clearly, focus, and exert the volition necessary to stop a destructive habit or condition. It varies by the individual, for many reasons, but I've certainly known individuals who stopped smoking and drinking cold turkey and didn't start again. It was not easy -- my ex told me that, 6 months after she stopped smoking, she was relaxing on the couch and was suddenly shocked by the realization that she was having a full-sensory hallucination of a lit cigarette between her fingers, for example -- but it was certainly possible. AA is such a crutch. They substitute a constant attention, an injunction that you must make the decision moment-by-moment, to not drink. They furnish you not only with the meetings and a room full of people who know what it feels like, the good and the bad, and a sponsor, who will keep on top of you, monitoring you, making sure that you don't lose focus and have 'just one'.

That said, AA goes further: It proposes to solve the problem of a lack of will to stop with the wills of a roomful of fellow addicts, who, repeating to you what they might not otherwise repeat to themselves, are getting "therapy" while dishing it out. AA insists that you are a permanent invalid, permanently weak and unable to 'fight' your own addiction. It takes for granted that you have no self-esteem and need to substitute the group's 'esteem' (or the mystical 'higher power').

In the short term, this approach can get you to a point where you are not drinking and are past the point of immediate physical cravings, which have a strong physiological component. Once you have gotten to that point, though, it continues to undercut the self-esteem that one would normally expect to build from having achieved such an accomplishment, at the very least, and continues to demand that you reiterate that "I am powerless over my addiction", the deference to a "higher power", and "I'm [blah blah] and I'm an Alcoholic!" etc. etc. The "powerless" mantra is its borrowing from Christianity, not just the "higher power". The two people in my life who successfully recovered both abandoned AA (something the organization insists is fatal to recovery) and substituted, instead, their own self-esteem, their pride in the life they have built for themselves, in which they've removed alcohol consumption, but which is otherwise quite full. I believe the argument that it is or isn't a religious creed may have to do with the two men who founded the movement, one a devout Christian, one not. But the root belief in the individual having somehow permanently lost their volition ('I'm powerless') and having to defer to a higher power, however the individual would like to interpret that higher power, is religious and is destructive in the way that religion is destructive to self-esteem.

Alcohol numbs the mind and prevents rational thought. Even a high-functioning individual like Thoyd is compromised. I remember a former alcoholic jazz musician, who played successfully for years while completely blitzed, who, when he was asked if he played better when drunk, said (from memory), 'hell no! I stunk. I just didn't know it and didn't care. I'm much better now'. It's amazing what we can do with half our brains tied behind our backs, but more amazing what we can do at full power. Once the individual experiences that, experiences the superiority of a life of reason and full awareness, it becomes much easier to abandon the things which prevent it.

I think that your analysis of AA is spot on, Alann. But I do not agree with you if you are saying that anti-psychotic drugs are merely a crutch to the recovering psychotic, as AA is to a recovering alchoholic. I believe that a psychosis per se, brings about *physical* changes in the psychotic´s brain, and those changes cannot be rectified by mere volition. I think that it stands to reason that the anti-psychotic drugs are *needed*. They are a necessay but *not sufficient* factor in the psychotic´s recovery. *Both* the drug(s) and the psychotic´s correct use of his volition are *necessary* for the psychotic´s recovery, and together they are also sufficient.

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I think that your analysis of AA is spot on, Alann. But I do not agree with you if you are saying that anti-psychotic drugs are merely a crutch to the recovering psychotic, as AA is to a recovering alchoholic. I believe that a psychosis per se, brings about *physical* changes in the psychotic´s brain, and those changes cannot be rectified by mere volition. I think that it stands to reason that the anti-psychotic drugs are *needed*. They are a necessay but *not sufficient* factor in the psychotic´s recovery. *Both* the drug(s) and the psychotic´s correct use of his volition are *necessary* for the psychotic´s recovery, and together they are also sufficient.

So I do not think that anti-psychotic drugs are just crutches which merely *help* the patient recover. I think that at least many pschotics *cannot* recover without the drugs, because of physical changes in their brains brought about by the psychosis. The fact that the drugs can work demonstrates that the physical changes are reversible, but I for one to not think that the physical changes in question are reversible by means of *volition*. I think that the physical changes are probably too drastic to be amenable to volition.

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I think that your analysis of AA is spot on, Alann. But I do not agree with you if you are saying that anti-psychotic drugs are merely a crutch to the recovering psychotic, as AA is to a recovering alchoholic. I believe that a psychosis per se, brings about *physical* changes in the psychotic´s brain, and those changes cannot be rectified by mere volition. I think that it stands to reason that the anti-psychotic drugs are *needed*. They are a necessay but *not sufficient* factor in the psychotic´s recovery. *Both* the drug(s) and the psychotic´s correct use of his volition are *necessary* for the psychotic´s recovery, and together they are also sufficient.

So I do not think that anti-psychotic drugs are just crutches which merely *help* the patient recover. I think that at least many pschotics *cannot* recover without the drugs, because of physical changes in their brains causing the psychosis. The fact that the drugs can work demonstrates that the physical changes are reversible, but I for one to not think that the physical changes in question are reversible by means of *volition*. I think that the physical changes are probably too drastic to be amenable to volition.

I'd agree with that. I put the term 'crutch' in quotes, because it's not just a prop, but you're right that psychosis is different than addiction: One is a physiological adaptation to a psychoactive substance that can cause immense pain and physiological disruption when discontinued, the other is a systematic dysfunction of the operation of the mind. The alcoholic's mind does not function well when the user is under the influence and, setting aside the painful effects of withdrawal, works much better when free of that influence. The psychotic's mind is dysfunctional under normal conditions and the medication brings it closer to normal function. So, obviously, there is a difference in how to treat the two. I meant that the pain, cravings, fear, and need to deal with emotionally painful issues from which the alcoholic may be escaping can be supplanted by AA, or other therapeutic support, until the patient has passed through the period of physical and, to some degree, psychological, withdrawal. That is a 'crutch' in a psychological sense of giving support, allowing the person to continue to progress away from dependence.

But you are right that an anti-psychotic drug is intended to be more than that. It should provide relief from the distortions caused by a dysfunctional brain. If ones hip were broken and not fixed and set, a crutch wouldn't solve the dysfunction, setting the bone and putting it in a cast, and maybe surgury, would first be required, or the damage might cause permanent disability. If a brain is not working correctly, talk therapy won't do much. The analogy of alcoholism and psychoses is a very limited one and probably not that useful. The issue of volition in psychoses is an interesting one, though. Many people don't do as well as you, not having the drive and strength of will to do all that is needed to recover. I know that the actual process of thinking can cause changes in PET scans and the implication is that permanent changes in brain function can come from changes in the way one uses that brain (ref: Annenberg series on The Brain), so I'd be willing to believe that cognitive therapy could improve the function of a psychotic mind in a more permanent way once drugs had "normalized" it to the point that such therapy could take place. You would know more about that. Both you and Bob Kolker are impressive to me in the way you have worked hard and effectively to overcome a cognitive handicap. I applaud you.

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I believe that a psychosis per se, brings about *physical* changes in the psychotic´s brain, and those changes cannot be rectified by mere volition.

Just a point of clarification: psychosis is a result of brain changes or abnormalities, not a cause of them.

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I believe that a psychosis per se, brings about *physical* changes in the psychotic´s brain, and those changes cannot be rectified by mere volition.

Just a point of clarification: psychosis is a result of brain changes or abnormalities, not a cause of them.

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I believe that a psychosis per se, brings about *physical* changes in the psychotic´s brain, and those changes cannot be rectified by mere volition.

Just a point of clarification: psychosis is a result of brain changes or abnormalities, not a cause of them.

I am not certain that that *always* is the case. I think that it is likely that causation in the brain/consciousness system can go "downwards" as well as "upwards". By "downwards" causation, I mean that if a certain thought. or a certain intense emotion brought about by a thought, persists long enough, it can cause a physical change in the brain. And by "upwards" causation, of course, I mean that a physical change in the brain, perhaps in the brain´s chemistry, can bring about a change in the subject´s consciousness.

An example of the former *might* be that thinking about the logical implications of altruism, combined with thinking about the view of the world conveyed in works of modern literature that I was required to read for English class (e.g. A Separate Peace and The Harvester in the Rye), combined with a great many other thoughts that I had at the time that I was a teenager, made me chronically depressed, and the chronic depression was so "strong" that it brought about physical changes in my brain that made me psychotic. This is my own personal hypothesis about how I became psychotic when I was 15 years old.

A simple example of the latter, would be - a person drinkgs alchohol and gets drunk. Or - a person suffering from depression takes an anti-depressive drug, and experiences a beneficial mood change. Or- a schizophrenic takes chlofpromazine, and mind "calms down", i.e. it becomes less hyperactive, so that the schizophrenic gains a better ability to concentrate on things, especially in external reality.

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Just a point of clarification: psychosis is a result of brain changes or abnormalities, not a cause of them.

I am not certain that that *always* is the case. I think that it is likely that causation in the brain/consciousness system can go "downwards" as well as "upwards". By "downwards" causation, I mean that if a certain thought. or a certain intense emotion brought about by a thought, persists long enough, it can cause a physical change in the brain. And by "upwards" causation, of course, I mean that a physical change in the brain, perhaps in the brain´s chemistry, can bring about a change in the subject´s consciousness.

An example of the former *might* be that thinking about the logical implications of altruism, combined with thinking about the view of the world conveyed in works of modern literature that I was required to read for English class (e.g. A Separate Peace and The Harvester in the Rye), combined with a great many other thoughts that I had at the time that I was a teenager, made me chronically depressed, and the chronic depression was so "strong" that it brought about physical changes in my brain that made me psychotic. This is my own personal hypothesis about how I became psychotic when I was 15 years old.

A simple example of the latter, would be - a person drinkgs alchohol and gets drunk. Or - a person suffering from depression takes an anti-depressive drug, and experiences a beneficial mood change. Or- a schizophrenic takes chlofpromazine, and mind "calms down", i.e. it becomes less hyperactive, so that the schizophrenic gains a better ability to concentrate on things, especially in external reality.

Psychosis can certainly be induced through substances (e.g., hallucinagens, methamphetamine) or severe and repeated psychological trauma. Substances alter brain chemistry and result in psychotic symptoms. Severe psychological trauma also, presumably, affects brain chemistry and functioning, thus resulting in psychotic symptoms. So, the symptoms of psychosis occur subsequent to the alteration of brain chemistry.

Put differently, psychosis and its symptoms are the manifestation of faulty brain chemistry and functioning, however it was induced. One couldn't say that someone is psychotic and has a normally functioning brain, and that if the psychosis was left untreated then the brain chemistry would become altered. One knows there is a problem with brain chemistry and functioning because of the psychotic symptoms.

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Just a point of clarification: psychosis is a result of brain changes or abnormalities, not a cause of them.

I am not certain that that *always* is the case. I think that it is likely that causation in the brain/consciousness system can go "downwards" as well as "upwards". By "downwards" causation, I mean that if a certain thought. or a certain intense emotion brought about by a thought, persists long enough, it can cause a physical change in the brain. And by "upwards" causation, of course, I mean that a physical change in the brain, perhaps in the brain´s chemistry, can bring about a change in the subject´s consciousness.

An example of the former *might* be that thinking about the logical implications of altruism, combined with thinking about the view of the world conveyed in works of modern literature that I was required to read for English class (e.g. A Separate Peace and The Harvester in the Rye), combined with a great many other thoughts that I had at the time that I was a teenager, made me chronically depressed, and the chronic depression was so "strong" that it brought about physical changes in my brain that made me psychotic. This is my own personal hypothesis about how I became psychotic when I was 15 years old.

A simple example of the latter, would be - a person drinkgs alchohol and gets drunk. Or - a person suffering from depression takes an anti-depressive drug, and experiences a beneficial mood change. Or- a schizophrenic takes chlofpromazine, and mind "calms down", i.e. it becomes less hyperactive, so that the schizophrenic gains a better ability to concentrate on things, especially in external reality.

Psychosis can certainly be induced through substances (e.g., hallucinagens, methamphetamine) or severe and repeated psychological trauma. Substances alter brain chemistry and result in psychotic symptoms. Severe psychological trauma also, presumably, affects brain chemistry and functioning, thus resulting in psychotic symptoms. So, the symptoms of psychosis occur subsequent to the alteration of brain chemistry.

Put differently, psychosis and its symptoms are the manifestation of faulty brain chemistry and functioning, however it was induced. One couldn't say that someone is psychotic and has a normally functioning brain, and that if the psychosis was left untreated then the brain chemistry would become altered. One knows there is a problem with brain chemistry and functioning because of the psychotic symptoms.

Yes, I agree with you now. I think that the *direct* cause of a psychosis is probably always a physically faulty brain function. But I suspect that the cause of the physically faulty brain function is at least sometimes the subject´s thinking, so that evil philosophical ideas can sometimes give rise to psychoses. But I think that it is likely that psychoses are *sometimes* caused by exclusively physical factors. If most of today´s psychiatrists, as I suspect is the case, assume that psychoses are *always' caused by exclusively physical factors, such as heredity, then I think that they are mistaken.

I am pretty certain that my own psychosis was caused, at least to a large extent, by the bad philosophical ideas that I was fed as a child, together with my failure to do enough thinking to be able to see through those bad ideas (I think that I could have averted my psychosis if I had done more independent thinking when I was a child, I would probably not have gone psychotic if I had been as heroic a thinker as Ayn Rand). I suspect that the psychiatric profession today underestimates the influence of philosophy on mens´ psychologies. I hope to help remedy that with the book that I am working on.

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It wasn't more than two years ago that I was drinking heavily to the point that I would be considered an alcoholic according to most definitions. As a result of my drinking certain events came about that convinced me to give Alcoholics Anonymous (AA) a try. So I did.

What I found attractive about the program, at least initially, were the stories I heard from other alcoholics. I could identify. It was easy to find commonalities in the stories told by others. I think a lot of AA newcomers are drawn by this. Additionally, people are friendly and understanding. They rally around the newcomer. They promise solutions. They give you a list of phone numbers and encourage you to call them if you feel like you are going to drink. They will also tell you to, "Keep coming back!." A person, half in a daze and very much vulnerable to such influence, can easily get sucked into the 12 step program.

It is my belief that AA plays no role in whether an individual quits drinking permanently. The motivation to quit drinking is already present in the individual that makes the conscious decision to attend their first meeting. In fact, I would argue that over time AA may actually play a role in encouraging people to drink again. Let me explain.

AA's bible, The Big Book, encourages the reader to rely less on reason and more on faith. Over-reliance on reason had been part of the problem, we are told. Each individual is encouraged to find a "God of their understanding." Once this is complete, and you have submitted yourself to the blind worship of some supernatural entity you are asked to confess all of your wrongs and shortcomings to your sponsor. You are expected to do this everyday for the rest of your life. Self-esteem doesn't stand a chance in such an environment. It's for these reasons that I believe AA actually encourages individuals back into the grips of their alcoholic addiction.

I realized this early on an ran as fast as I could the other way.

I could ramble on indefinitely about this topic. I'll let it rest here.

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I could ramble on indefinitely about this topic. I'll let it rest here.

That's an interesting inside perspective---thanks for sharing!

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I have been a sober for a little over a year, largely as a result of working an AA program.

You all should consider the fact that addicts and alcoholics who are dieing from drug/alcohol addiction are less concerned with dissecting the intricacies of a plausible solution to the problem as they are giving it a shot, and hopefully restoring themselves to health.

Here's why I think it works for myself and many others: (whether there is a God or not, which I personally think there is)

By "creating one's own conception of God", what you essentially do is define your values. By giving your life and will to that "God", you are deciding to live according to your values, which to me is rational.

As Ayn Rand says (paraphrase)

"Happiness results from the achievement of one's values."

Not to mention taking suggestions from those who have been able to do something that I have not is rational.

I don't agree with everything in the Big Book of AA, though. Particularly on relying less on my thinking. I do my best to expand upon it today, and I am doing well.

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Any "program" that appeals to a higher power than one's own good sense is bogus.

Bob Kolker

I explained this in the above post. Because it is "of your own conception" it's really your own standards and values.

In this sense it would make a person who previously did not live according to their values make a decision to strive to do so.

Getting sober and working an AA program is the best, most rational thing I've done in my life.

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Any "program" that appeals to a higher power than one's own good sense is bogus.

Bob Kolker

I explained this in the above post. Because it is "of your own conception" it's really your own standards and values.

In this sense it would make a person who previously did not live according to their values make a decision to strive to do so.

Getting sober and working an AA program is the best, most rational thing I've done in my life.

Congratulations on your success.

I followed a different path; I never became addicted to any substance except coffee, which is Columbia's number two cash crop.

In that last analysis, whatever works, works.

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