12 Steps of Grey
A recent episode of This American Life profiled Tina Dupuy, a girl who started going to AA at age 13. Even after 20 years of sobriety, Tina still went to meetings once a month, but she suddenly started to wonder if she really ever was an alcoholic. What if she could have just one drink? Sure, it’s the thought that plagues every alcoholic, but Tina really started to doubt the entire system she was raised in. In AA, just barely a teenager, Tina learned that she was an alcoholic because she had a disease. And everything bad that had happened to her was her fault because she’s an alcoholic. Tina never attributed her drinking to her tumultuous and abusive family situation—her parents founding a religious cult, committing her to a psychiatric ward for 30 days at age 11, and then finally giving her up as a ward of the state where she lived in a girls’ home until finishing high school. In AA, Tina related to other members’ feelings of being rejected by their families, winding up in the hospital, feeling trapped and desperate. “If Tina was an alcoholic, everything made sense. She was the problem. She was the only problem, and if she stuck with the program, she could fix the problem.” But at 33 years old, she began to wonder if maybe her childhood had something to do with why she drank back then, and she started to wonder if maybe she really wasn’t a lifelong alcoholic. So she and her husband planned a special dinner for Tina to have her first sip of wine in 20 years. And what happened? She had a glass of wine and went to sleep. It was uneventful. And now she has been drinking for almost a year, never having more than one or two drinks. Nothing in her life changed—except she doesn’t identify herself as an alcoholic anymore.
I always used to hate stories like these. Stories of the alcoholic who found a way to “drink normally,” because I was always informed by counselors, doctors, and family members that only 5% of alcoholics can ever drink again, and I was definitely not among them. I had crossed the invisible line. Nearly a decade of alcoholism—the last five years of which often consisted of drinking a fifth of whiskey a day—you can’t just come back from that. And in the first year-and-a-half of my recovery, I learned over and over again that I could never drink normally. Now, having been sober for two years, I have almost no desire to drink, and I am not envious of those who can drink normally—but I still feel a pang of anger that stories like these seem to discredit the idea of alcoholism entirely.
As a scientist, I know how the brain and body can become physically dependent on alcohol—it’s not just a matter of willpower. But as a recovered alcoholic, I also know that alcohol is used by most as self-medication. So what if you get to the root of your problems and don’t need to self-medicate anymore? Are you still an alcoholic? I don’t think stories like Tina’s dismantle the biological basis of addiction, but they may dismantle the basis of the 12-step program. A new article in The Atlantic details the history of AA, how there is no evidence that the approach of the Program is the best or only way (or even a healthy way at all) to get sober, and how science has offered dozens of other more effective treatments for addiction. This article is one of the best I’ve read that takes a stance opposed to AA. In my book, I briefly recount my own AA experience:
When I first quit drinking, I thought that if a drop of alcohol ever touched my lips again, I would immediately burst into flames and die. Realizing that it was possible to socially drink was initially reassuring—I could just have one or two beers and not go off the deep end for another eight years, which meant I really had my life under control. The feeling of having power over alcohol was almost more intoxicating than the liquor itself, and all I wanted was to be in control. One of the biggest problems I had with AA was admitting that I was powerless over alcohol, which was step one, so I obviously wasn’t going to get very far with that program. I just couldn’t tolerate thinking that I was powerless over anything. I’d had my power taken from me, and I wasn’t going to lose whatever power I had left to anything again, not even alcohol.
AA may have actually hindered my development out of addiction by keeping me in constant fear of a relapse. I was convinced that my addiction was always out there waiting to sneak up on me at any moment, and I had to constantly be hypervigilant about my internal and external environment because any mistake, even one drink, could lead to a full-scale relapse. AA encouraged me to define myself as an alcoholic/addict for the rest of my life, and by revisiting my alcohol-related memories and hearing others talk about their alcohol disasters, I was constantly reliving my memories of addiction and all the emotions that came with it—just like my other PTSD symptoms. I was living with constant anxiety, fear, and avoiding any people or places that reminded me of my addiction. For some people, this may be the only way to stay clean and sober, but for me, living with fear and constant reminders of past horrors was exactly what I was trying to remedy.
I remember my first inkling that something wasn’t quite right in AA. Another member was in excruciating pain due to a work-related injury but refused to take pain medication because that would be a relapse according to AA. A real addict wouldn’t be able to have a bottle of Vicodin without downing the whole thing in one day. I could relate to that—I had downed my fair share of prescription meds—but when the other members started attributing her pain to just the “decreased pain tolerance” that all recovering alcoholics experience, I saw how this program was possibly preventing her from getting the medical help she needed. You can’t just blame every single mishap and bad experience on alcohol and alcohol alone. Sometimes these things do have an outside cause, and sometimes (more often than not) alcoholism has an outside instigator—abuse, neglect, poverty, violence, trauma.
And then, toward the end of my first year of recovery, it hit me—the 9 year anniversary of my rape, and the first year I would face this time sober. I was not prepared for what we call an “anniversary reaction” in PTSD, which can range from mild distress to more extreme re-experiencing, panic attacks, or suicidality. I’ll just say that my reaction was on the extreme side, but when I scheduled an emergency appointment with a psychiatrist, I refused to take the medication that probably would have given me a great deal of relief. I knew if I had a bottle of Ativan or Valium or Xanax, it wouldn’t last me more than a few hours. Or would it have? Something I have learned in teaching is that if you expect students to fail, they will. Or at least more of them will fail than if you expect them to succeed—and treat them like they will succeed. If AA expects me to swallow an entire bottle of pills in two hours, I probably will.
I was never sober for more than a few weeks at a time when I was going to AA. And once I realized that AA was just causing me to live in fear all the time, I stopped going to meetings and started drinking again in what I determined were “normal amounts in normal situations.” But unlike Tina Dupuy who was able to drink normally, I could not. Okay, so I really was an alcoholic. Or was I? At that time, I also had an extremely unstable and painful life that was frankly quite hard to face sober. Living without alcohol is one challenge, but learning to live—actually live—sober is the true challenge, for anyone, alcoholic or not.
But I knew that I really needed to be sober to do the healing work that I needed to do to get my life back together—I believed my brain and body biologically could not make the changes that needed to be made when excessive amounts of alcohol were present in my system. So a major turning point in my sobriety came when I realized that yes, I did want and need to abstain from alcohol, but if I did drink for whatever reason, it wouldn’t be the end of the world. I’d get back on track. It wouldn’t be “7 times harder to quit each time you start,” as my mom used to say. I wouldn’t get hurled into another decade of misery. I’d be okay. When I stopped constantly hearing that I would fail, I stopped failing. And I started taking medication for my anxiety—and taking it exactly as prescribed. Even with a high-risk-for-abuse drug like Ativan, I ended up throwing them away because I wasn’t taking them. Gradually, my sobriety became less and less of the “white-knuckle” variety until I finally had what, unbeknownst to me at the time, would be my last drink. You can read the account of my last drink here and here. It was when I knew that I could heal and I could be loved and I could make mistakes and bounce back—that I could live and I deserved to live—that I finally got sober.