http://www.scientificamerican.com/ar...anonymous-work
The Effectiveness of the Twelve-Step Treatment
http://www.bettyfordcenter.org/treat...ccess-rate.php
(Refer to response #17. It's written specifically for you, Nozz!) J/K!
http://news.nationalgeographic.com/n...rapy-dopamine/
(Refer to "Left Brain, Right Brain" and "Helping Heals.")
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Originally Posted by Nozzferrahhtoo
An easy mistake I guess, compounded somewhat perhaps by this Charlie Sheen like oddity you have of referring to yourself in the third person which makes parsing the meaning and intention of such lines that little bit harder.
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Point taken. For the sake of clarity, and for those who find the "third person posts" annoying, this one is an "in the first-person" written post.
In all honesty, I truly have no idea why I adapted the "third person" writing style, other than to say that I think I initially found it amusing, and over time, it simply became a "force of habit." It's just "June."
--Besides, it's
a message board. Given that factor, truly, what do I care if I ended up adapting the quirky third person writing style that I have? I don't.
Admittedly, members either love it or hate it, (and thanks to all those who over the years have actually repped me for it, for goodness sake, saying they love it, which just cracks "June" up! LOL!)
We're all posting under the auspices of anonymity (except in those cases where true friendships have been formed) so in short, for those who hate it, my apologies for annoying (Lord knows I don't intend to!) but at the end of the day, all I can say is that it's the contents of any given post that count. If the third person detracts from, or impedes in getting the contents of a post across, then that's "June's bad." Admittedly. But like I said, it's a message board for goodness sake, and everyone reads a whole lot of what they find "way out there" on a daily basis, so if ya want, just chalk the third person up to being just more of the same.
So with that out of the way, first off, I'll respond to your point stated here, Nozz:
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Originally Posted by Nozzferrahtoo
The phrase "agree to disagree" to me has always sat badly as if it just means "Lets give up on discourse because it is not going the way I personally want it to". I never agree to disagree, rather I endevour to strive towards the ideal of mutual consensus.
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While in theory the concept of "striving towards the ideal of mutual consensus" is a nice one, the reality is that there are situations in this world where individuals are simply not going to achieve "mutual consensus" no matter how long or hard they try. It's just the way it is, as individual's opinions and beliefs are integral entities to them, and highly defended by them, as a result. I'll "agree to disagree" solely due to the fact that I know all too well (as can anyone else just by reading the debates on the various threads on this message board) that mutual consensus is not always achievable, yet nonetheless will still respect another person irrespective of how adamantly we may disagree. People are entitled to what they believe to be true for them; there opinions matter and count, so at the end of the day, "agreeing to disagree" is not perceived on my part as "Let's give up on a discourse because it is not going the way I personally want it to", but rather, because I don't have a problem with those who don't see things the same ways as I do. There's no overly narcissistic ego to be found in my emotional constitution, so I'm fine with agreeing to disagree, if for no other reason (as I've already mentioned) out of respect for the other's opinions, and a means of "keeping the peace." Please note: This paragraph should NOT be interpreted in any remote way as my accusing you of having an overly narcissistic ego. Rather, I have posted it by way of stating where I am coming from, and why. (Just...wanted....to....be....clear....on....that. ...one!)
With that being said, in a state of sheer frustration and angst, I wish to respond to what you said about methodology and statistics in proving one's claim. I say that it is with "sheer frustration and angst" because no sooner did I write out a nicely constructed paragraph in response, than my computer decided to somehow delete it.
(You ain't sending June self-sabotaging vibes across the Pond, are you, Nozz?)
But in trying to go back and reconstruct what I wrote, I can only say that I both agree and disagree with you when it comes to statistics and the methodologies by which they are garnered in accessing the efficacy of the AA model of recovery. As someone who works in the field of being a professional mathematician once said to me: "Data and statistics can be readily manipulated such that one can easily render statistics to support whatever stance one wishes to support or endorse in any subject study." --I don't know that I necessarily agree or adhere to that claim, especially as regards the issue of efficacy as it pertains to AA in general, and the Twelve Steps, in particular. Lord knows I've been exposed to more than enough double blind studies in my all too lengthy years of academia (seriously, it was torture at times!)
so my feeling is both a "yes" to statistical analyses and renderings, along with a "no" as regards the utilization of such methodologies in determining the efficacy and success ratings of any Twelve Step based program.
I think this comes down to how one defines "success rate" as regards any individual and the utilization of the Twelve Steps that AA endorses. Thus, my quoting your post, below:
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Originally Posted by Nozzferrahhtoo
Indeed you are right but this is recognized as probably the single biggest issue with evaluating the actual efficacy of the AA program. Basically it is a correlation-causation error.
The people most driven to attend the meetings long term... are likely the people most driven to succeed and better themselves.... therefore the most likely to do so.
Therefore while long term AA attendance _correlates_ strongly with long term sobriety... there is no clear cut reason to allocate that success to AA or anything to do with AA per se.
This is a confounding factor that is something we can deal with using studies that engage with the epidemiological methodologies that will account for it and mitigate it. Alas the number of studies that ACTUALLY do so are thin on the ground. Especially studies sanctioned or commissioned by AA themselves as they clearly recognise that the above makes their figures look good.
Those studies of that type that do exist however do not portray the success rates of AA in a good light at all at all.
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I maybe mis-reading or misunderstanding what you are saying above, but it seems to me that your third and fourth paragraphs are contradicting themselves. (???) I absolutely agree with your statement that "The people most driven to attend the meetings long term... are likely the people most driven to succeed and better themselves.... therefore the most likely to do so." but you then turn around and claim that "there is no clear cut reason to allocate that success to AA or anything to do with AA per se." Nozz, if you actually speak to individuals who have been in long term recovery, and listen to what they have to say as regards what working the Twelve Steps of AA enabled them to attain or achieve, there exists a very clear correlation between the efficacy of those Twelve Steps, and a given individual's recovery in having turned their lives around due to having done so. At the very least, the Twelve Steps provide a treatment modality by which an individual is both introspectively driven to assess, and thereby eradicate their own denial as regards their substance abuse (which is the key component of any substance abuser's addiction, and what keeps them drinking or drugging) along with the cognitive-behavioral restructuring that takes place which enables an individual to maintain a state of sobriety. Cognitive restructuring takes place over time within the person's brain; new nuero-pathways are formed. In short, sobriety can be achieved and maintained via the utilization of working the Twelve Steps of recovery.
So for those who do, the "success rate" index of the Twelve Steps is exceedingly high. --But the individual has to do the work of those Twelve Steps.
From what I have found, the literature tends to be very diverse as regards the overall "success rate" of the Twelve Steps. If one takes a purely statistically-based standpoint, then there is no lack of supporting evidence in the literature to support the notion of the Twelve Steps, and AA in general having little efficacy, or perhaps at best, moderate success rates. But this is
addiction that we're talking about here. The statistics and/or realities behind what would account for the abysmal "success rates" of AA come as no surprise, as it's an extremely tall order when it comes to battling one's own brain's bio-chemistry, along with the external environmental factors that have been set in place in a person's life throughout the course of their growing up. (Which only serve to reinforce an addiction that much more, and cannot be separated from the overall dynamics which go into what comprises "addiction.") To be perfectly honest, as a clinician, I tend to not only expect a high relapse rate or index in patients upon initially trying to obtain sobriety, and as any well trained and well seasoned psychotherapist who has a specialization in substance abuse will tell you, "relapse" is actually a component OF "recovery," believe it or not! (Admittedly, that last point comes across as more than just an obscure one, but I've got to tell you, it's true!)
At the end of the day, one can't negate the role that self-volition plays in any person's ability to achieve and maintain long term sobriety, and
true recovery. The concepts of "sobriety" and "recovery" are
not defined by mere abstinence from a substance alone. A state of sobriety, and what constitutes true recovery is based in the cognitive-behavioral changes that take place in an individual, that are sustained over time, such that a person's life is transformed from that of being held hostage (if you will) by either alcohol or a drug, to being able to live a productive, self-gratifying life that is indicative of sound mental health, and is backed up by, supported by that. One of the individuals I worked with at one time had lost everything in his life due to his being a poly-substance abuser. He ended up homeless, living under a tree for God-only-knows how many years, until his body began to give out from under him, at which point he ended up admitting himself into de-tox (as by that point de-tox was a medical necessity) and from there, proceeded to get himself into AA, worked the Twelve Steps, and at the point that we terminated therapy together, he was gainfully employed in a well paying job, was in the process of attempting to reunite with his children, and had met a woman who was fully supportive of him and whom he hoped to marry. For him, his "succes" was solely attributable to his having finally gotten into AA, and working the Twelve Steps. And he was by no means a religiously-oriented individual, so the "god factor" in no way impeded his ability to attain recovery.
I don't know what more I can say in response.
In order to bring this post (and thread) back around to the topic of "AA selling religion" I will once again say that I feel that is totally attributed to the cultural mindsets of the originators of AA. They were both Christians, living in a Judeo-Christian culture, and felt that there was much merit in the existence of a spiritual component in the process of recovery through the Twelve Steps. And although I have to go back and recheck the Twelves Steps, if I'm not mistaken, it specifically states (as regards the "Higher Power" notion) something to the effect of "as we understand him." (Please don't hold me as "etching this in stone" as I didn't reread the Twelve Steps prior to responding to your post, but will after posting it.) --But I do know that no one is beaten over the head with a bible in the halls of AA, and that "Higher Power" is left to the individual's conceptualization of whatever he or she deems fit as regarding it as.
Or not. Again, there is no lack of atheists who are clean and sober today despite their flat-out refusal to adhering to the notion of a higher power. Do I readily admit that the "higher power" that the Twelve Steps are referring to is rooted in, and can clearly be gleaned to be that of a Judeo-Christian one? Yes. But it is
not exclusive to the notion of a being a purely Judeo-Christian God. Talk to people who are in AA, who do not accept the notion of a Judeo-Christian god, and see what they have to tell you! Some believe in one, some don't, some AA/NA meetings are very religiously-oriented in their emphasis on the necessity of a Higher Power, but there's no lack of meetings (at least here in Massachusetts) where the "higher power" concept
is not found being crammed down people's throats. No one is forced to believe in, or adhere to the notion of a "higher power" being a strictly Judeo-Christian deity. I have no doubt that the culture of AA has changed over time just as the overall culture as a whole has, such that the "higher power" notion has become that much more of an eclectic one. It may not have started out that way initially, but I can tell you that if you walk into an AA meeting here, today, the interpretation of a higher power is left to the individual in terms of how it is conceptualized. Or not.
So, that's about it. I don't know what more I can say, other than the fact that if a person
truly wants it, true sobriety and recovery can be had, and is to found within the halls of AA. If nothing else, I can't say otherwise, as I've worked in this field for far too long to either negate or dismiss the efficacy of AA and the Twelve Steps as I've seen how it has worked for multitudes of individuals. Who, in my personal and professional opinion, are the lucky ones. Because I'll also be the first to admit that it isn't easy, in fact it can be as difficult as hell, and all too sadly, there are those individuals for whom AA has little or nothing to offer, and who are still leading lives that they otherwise wish they were not.
So in the end, June agrees with some of your points, disagrees with others, but like I said at the start of this post, not everyone is going to be able to reach a final position of mutual consensus, which is okay. --Because when you think about it, how much less fun and enjoyment would there have been for either of us in debating and bantering this topic back and forth? Yes?
--As a pure act of goodwill, I will try to make it a point of raising a glass, and taking a sip of Chimay in your honor over the holidays, Nozz. (Although I've got to say, I've truly long since lost all taste in the stuff! Blech! But the sentiment will still be nonetheless genuine!)
Thus ends June's "first person post" and thereby re-commences her resuming her quirky, overly-annoying to some third person posting. With sincere apologies to those who she either offends or annoys. (But seriously, people, it's a
message board! If ya want, just write June off as being a PSYCHOtherapist. That's fine with her. It's all in the nature of light-hearted fun!)
P.S. In response to your saying:
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Originally Posted by Nozzferrahhtoo
I like to remain vague about my personal life and qualifications. Not least because my points should stand alone, and not be bolstered by who or what I claim to be.
However I will briefly say that I am heavily schooled and studied in epidemiology methodologies, specifically in areas related not to disease but the treatment of conditions, ailments, and complaints in the areas of human psychology, psychotherapy, and psychiatry. I am also heavily studied in Human Neuroscience. Basically for a long time every aspect of the human mind, physically, chemically and mentally, has been of great interest to me and I study if from all angles internally and externally and how we treat it, medically and through therapy, when things go wrong with it physically and mentally and emotionally.
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I'm with you on your first sentence. But if a note needs to be made in terms of my "qualifications" it can be found referenced to within at least 2 of the links at the top of this post, in indicating where boatloads of my academic life was spent in Advanced Clinical Training. And yes, I'm the first to admit that I
hate the snooty aspect of it, (and hence, am loathe to disclose it!) but have to say, it provided one hell of a
fine education!
P.S. PLEASE tell me that the links at the top of this post can be opened! In proof-reading this post, they initially would upon clicking on them, but the second time around, no-go!
If such is the case, we all know where they can be found. (We're really not allowed to refer CD members to "you know where" so I'll let it suffice at that!)
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Third person, first person, right brain, left brain, and on and on we go! :)
