According to a recent piece in Wired magazine, 75 years after the founding of Alcoholics Anonymous, it's still not clear how and why the group works. Reporter Brendan Koerner
goes through the complexities of the program's mysterious failure and success rates, and examines possible mechanisms for breaking through addiction, evidence of selection bias among members, and more. A thoughtful conversation
has now sprung up around the topic.
- AA: 'Transformative,' When It Works It doesn't always work, Koerner
hastens to add. But when the transformation does occur, "what aspect of
the program deserves most of the credit?" And could the program be made
better? The "power of the group," it turns out, may be more important
than the actual 12-step program. The lack of professionals can be a
handicap, but also an asset, "help[ing] foster a sense of intimacy
between members." There's also "evidence that the act of public
confession ... plays an especially crucial role" by increasing
self-awareness and "reinvigorat[ing] the prefrontal cortex, a part of
the brain that is gravely weakened by alcohol abuse." But on the other
hand, it's also possible AA success has to do with its members: it's
"known for doing a better job of retaining drinkers who've hit rock
bottom," who may be so desperate they're headed for sobriety anyway.
Koerner identifies a few areas--figuring out how to deal with unhelpful
members, increasing openness to medication--where AA might also improve.
- One Idea: Addiction and the Ability to Predict Jonah Lehrer's
got another possible answer to the mystery of AA's success. In our
brains, he explains at The Frontal Cortex, "a prediction error signal
occurs when we expect to get a reward--and it doesn't matter if the
reward is money, sex, praise or drugs--and we instead get nothing." We
expect happiness from alcohol and only get it for a few minutes. "Why,
then, do addicts keep on drinking? One possible explanation is that
addicts can't properly process their prediction errors, so that all
those negative outcomes get ignored." Thus (and he admits this is
"blatant speculation"), AA might succeed because it's "designed to
force people to confront their prediction errors." Many of the twelve
steps are "all about the admission of mistakes."
- A Pre-modern Approach to 'Changing Lives' The New York Times' David Brooks
looks at the broader public policy interests in "get[ting] people to
behave in their own long-term interests--to finish school, get married,
avoid gangs, lose weight, save money. Because the soul is so
complicated, much of what we do fails." Koerner's piece, he argues,
teaches us "that we should get used to the idea that we will fail most
of the time." But Brooks is also fascinated by the ways in which AA
culture adopt some of the best practices not always present in
our current society: "In a culture that generally celebrates
empowerment and self-esteem, A.A. begins with disempowerment ... In a
world in which gurus try to carefully design and impose their ideas,
Wilson surrendered control."His conclusion:
In the business of changing lives, the straight path is rarely the best
one. A.A. illustrates that even in an age of scientific advance, it is
still ancient insights into human nature that work best. Wilson built a
remarkable organization on a nighttime spiritual epiphany.
Want to add to this story? Let us know in comments
or send an email to the author at
hhorn at theatlantic dot com.
You can share ideas for stories on the Open Wire.