October 2, 2006: Part One
Addiction perplexes and intrigues me. There are obvious personal reasons for this — I was addicted to alcohol for around ten years until October 2, 2006 — and I find the whole subject an enticing and elusive intellectual puzzle. The origins and causes of addiction are essentially a mystery and its treatments are notoriously random and sporadically effective at best. The medical profession, who are enamored with certainty, have all but outsourced its management to a non-existent god in the form of 12-step programs that, according to screeds of research, are either marginally effective or not effective at all.
My own experience with Alcoholics Anonymous persuaded me it is the world’s most elaborate placebo trial: if you believe hard enough, it may just work. Certainly, the “success stories” of AA are typically people with a certain cultish vibe, right down to the chanting of prayers and platitudes…”one day at a time”, “the elevator to sobriety is broken, take the steps!”, “Seven missed meetings makes one weak!”. The over-reliance on exclamation marks, and the non-ironic reveling in word-play, were early signs that I would not be an AA “lifer”.
At the heart of AA-world is the anthropomorphication of alcohol. AA members characterize booze as a nemesis with human, and inhumane, qualities. Grog itself — the actual liquid in the glass — is evil, pernicious, endlessly capable of plotting. It is out to get you! In most AA meeting soliloquies, the word alcohol could be replaced with the name of an abusive parent or partner without losing anything in coherence.
This is not to say I am anti-AA. For the first 3-6 months after I downed my last drink, it helped me. More than anything, it gave me something to do with the relentless hours and days of early sobriety. Also, I put together a confessional spiel — “Hi, I’m Phil and I’m an alcoholic”, “Hi, Phil!!!” — that proved quite popular among the AA faithful and gave me a timely ego boost ever time I delivered it (which was at every meeting; I was fresh meat and the throng couldn’t wait to hear what depths of depravity I had reached).
AA soon lost its appeal for me, but it undeniably works well for some people. It provides a supportive network of relatively non-judgmental and like-minded souls, and regular meetings certainly act as a buffer between the tenuously sober and relapse. But I could never shake the nagging feeling that the whole exercise was kind of missing the point.
From my experience, I felt that alcohol was a means to intoxication, and intoxication was a ticket out of reality, and reality was shit. The shiteousness of reality, therefore, struck me as main game.
For a booze-hound, as long as the calculation remains that being drunk — with all its dreary and dreadful personal costs — is preferable to being sober, then all the AA meetings in the world won’t keep you on the wagon. This assessment misses one obvious element — namely, that drinking (or drugging) to “self-medicate” actually makes the original condition worse, creating a misery spiral. I hate my life — I drink – my life gets even worse — I drink more — and so on.
The alcoholic keeps drinking — the exaggerated and easily treatable physiological dependence aside — because the hypothetical notion of a contented sober life is fantastical. If they were happy sober, they wouldn’t have ended up drunk.
At best, then, AA is a form of cognitive behaviour therapy — symptom treatment — and that’s not nothing. It is certainly better for a miserable drunk to be simply miserable, just as it is a good idea to train anorexics how to eat properly, or the obsessively hygienic to cease their irritating compulsions. But it leaves the black box — the reason we drank to begin with — untouched and, as long as that is case, the prospect of either relapse or the emergence of new symptoms seems inevitable to me. Never met an edgy, intense, chain-smoking, instant-coffee swilling, sex-obsessed recovering boozer? Find a church hall and wait a few hours.
If I am right — and this is one area where I am chronically unsure of myself — then this represents a direct challenge to the AA philosophy which is that sobriety is an end in itself; and that active non-drinking is the one and only answer. In response to my half-formed ideas, AA types will undoubtedly pull out the disease card: alcoholism, so it goes, is a disease, often inherited, for which there is no cure.
My cursory reading on the disease concept is that it began life as an instructive metaphor — alcoholism is very much like a disease — but it has taken on a literal meaning. I heard several AA members describe their condition as being akin to diabetes or heart disease, to which there is only one possible response: “Um, no it isn’t”.
As far as it goes, the disease metaphor is a useful way of focussing the attention of the addict on the chronic nature of their problem — but it is easy to stretch this to breaking point. Granted, there is a well-established genetic predisposition to alcohol abuse — my Irish ancestors, for example, were rarely sober — but this, I suspect, is far less significant that what it seems. In my case, it probably made it far more likely that I would resort to grog as my escape of choice than, say, self-mutilation or bulimia — but what else does it prove? Untroubled, the black box gathers dust.
AA adherents will have one of two responses to this: either, I am an alcoholic in denial on a one-way fast-track to relapse, or I was never really an alcoholic to begin with. To the true believers, it is simply inconceivable that sobriety can ever be achieved without the 12 steps, despite mountains of empirical evidence that it happens all the time. For them, the key to a sober life is to focus on not drinking with the same single-minded ferocity that they applied to getting hammered. But such an approach seems to me like a permanent, self-imposed and entirely avoidable hangover.