The “Irrational” AA Article and It’s Blowback

Earlier this week, an article from The Atlantic titled “The Irrationality of Alcoholics Anonymous” was widely read and discussed. It started a vigorous debate.

Two articles on the reaction:

The High Functioning Alcoholic from Psychology Today

Spirituality vs. Science from the Huffington Post

A blog reaction:

Trashing AA as Irrational

And a TV clip:

Does AA Really Work? from MSNBC. This clip had two women discuss it. I have to say, especially for TV (and cable tv, no less), that the discussion was equal and measured. No shouting or namecalling or casual dismissing.

A few thoughts of mine:

(1) Too many treatment programs rely too much on the 12-Step Model.

(2) Those that do rely on the 12-Step Model tend to discount medication and a number of behavioral therapies that have strong outcomes (and data to back it up).

(3) I have personally and professionally seen AA be wildly successful for thousands of individuals.

(4) I agree that AA’s strongest aspect is the power of the group. The creation of a social network and a collection of some inspirational role models.

(5) In summation, AA is a wonderful program that helps lots of people. Treatment programs need to offer more than just AA though.

The Hidden Wounds of Sexual Assault

A few months ago, I was talking with someone I’m very close to about sexual assaults on college campuses, in the military, and generally throughout America. I told her how 1 in 4 women in the United States will be sexually assaulted at some point in their lifetime, and how that number jumps to 1 in 2 if a woman has a substance use disorder. I spoke about how 80% of survivors are under the age of 30, and how often colleges typically mess up the less than 5% of cases that are reported.

She responded, “Something happened in the last year.”

“What do you mean?”

“You’ve talked about sexual assaults for the last half decade, but nothing like you’ve done in the last year. Something happened to someone you know. One of your clients maybe.”

I stopped and thought about it. I sat down and thought some more. “Over the last dozen years, I have heard a great many stories involving sexual assault and rape. Some of them were particularly gruesome and heinous,” I said. “But it’s not just the incident. The mental, emotional and spiritual toll that these women have experienced and endure has long lasting consequences and affects many different areas of their lives. The sum total of it all has left me deeply affected, concerned and angry.”

Here are a few examples of what I’ve helped women process through the last few years:

(1) Jane Doe #1: Went to a highly regarded, small, private, liberal arts college in the Mid-West. Was raped at the end of a date. She told her friends about it a few days later, and they told her she hadn’t been raped. “Those kind of things happen,” her friends (all females) told her. A few weeks later, she realized she had been raped. She didn’t tell her friends. She didn’t go to see a counselor or a police officer. Years later, she told me that, “I felt stupid for taking so long to work out what happened.”

(2) Jane Doe #2: Attends school at a major public university. Was raped on four different occasions by four different men that she considered friends. She didn’t report any of them to the police. She did tell two of her female friends. She is currently experiencing major academic, social and physical problems (none of which pre-existed the first rape). She will only leave her house during the day if someone else accompanies her. She will not go out at night.

(3) Jane Doe #3: While at an off-campus fraternity party, she was cornered into a bedroom by a “giant.” She reported that he threw her down on a bed, choked her and raped her. He told her that if she ever reported him that he would kill her. A year later, her PTSD was causing her so many problems that she sought counseling. She declined to inform the authorities.

(4) Jane Doe #4: A woman in her early 20’s met a 29 year old man at a self-help group for people with alcohol problems. They hung out twice after a meetings: they got coffee after the first meeting; he raped her in his car after the second meeting. “I felt so stupid and ashamed. It was my fault,” she told me.

Think for a moment about how difficult it is to tell someone about a problem. Think what it took for these young women to tell a man in his late 30’s about this (research states that women have an easier time talking to other women about these issues). Most never go to the police or even a counselor. Less than 5% of sexual assaults are every reported.

To my knowledge, none of the aforementioned women ever told any of their family members. Read that last line again. If there is a female in your life under the age of 30, there is almost a 25% chance that she was sexually assaulted and never told a family member. If it is your daughter, sister or grand-daughter, you might have no idea of the hidden wounds that she has been carrying around.

Their stories are not unique. They are just examples of cases that are all too common. Many of the women I’ve talked to or worked with:

– are afraid of people

– are afraid of the dark

– jump when touched

– get alarmed at loud or sudden noises

– have difficulty being intimate with someone

– have problems in relationships

– were not believed by friends, boyfriends, family members or the authorities

– ….as a result, they trust people less

It seems like sexual assaults have been reported more frequently in the last dozen years. Colleges and the military have had national scandals and leaders called onto the carpet for the failures of reporting and treating women that have been sexually assaulted at those institutions. And yet on Friday, an article appeared on about how College Presidents Appear Delusional about Sexual Assaults on Their Campuses. Those in power are acknowledging, more than ever, that sexual assaults are on the rise and that they are a significant problem. They just don’t believe it is happening in their backyard or is their responsibility. Most of those in power that aren’t properly addressing this are men. To sum it all up: these sexual crimes are being committed by men, and then other men are glossing it over or disregarding it. It’s time that we educate men on these issues, rather than just focusing on what women can do to prevent them.


This is a great site for information regarding sexual campus policies, reporting, activism, and alcohol and drug use. I urge you to learn more and tell others.

For the parents of young adults with a substance use disorder

According to the 2013 National Survey on Drug Use and Health (the most recent survey available to us) and the latest findings by the National Institute on Drug Abuse (NIDA), these are the percentages of young adults, aged 18 – 25, that do the following:

– 39% of full-time college students report engaging in binge drinking within the last month (this number is 33% for those in not in college or part-time)
– 19% report using marijuana within the last month
– 22% report using illicit drugs (Molly, heroin, opiate painkillers, methamphetamine) within the last month
– 13% report abusing prescription drugs within the last month

People who abuse alcohol and/or drugs are more likely to get injured, have a mental health disorder, be involved in sexual assault, have legal problems, and attempt suicide. It’s a huge risk factor that can also lead to school, work and family problems. If you are a parent of someone aged 18 to 25, you may have already seen your child experience some of these issues. At the very least, you probably have some concerns. I’ve worked as a therapist with this population for 12 years and I’ve run programs at high schools, universities, in-patient and out-patient treatment centers. Here are some simple tips, based on those experiences:

– be a role model -> young adults with a parent who abuses alcohol/drugs are much more likely to have substance use disorder themselves
– talk to your young adult about school, friends and substance use
– engage in activities outside of your home with your offspring (too many relationships get bogged down by the business of housekeeping (shopping, cooking, cleaning, laundry) and not enough families engage in fun or recreational pursuits

If you suspect or know that your young adult has a drug or alcohol problem, here are some further actions that you can take:

– get your young adult into counseling immediately
– accept that everyone who lives with someone with a substance problem is affected
– do not have alcohol or drugs in the house
– abstain from alcohol and/or drug use while your offspring is in treatment or trying to stay clean
– attend at least six Al-Anon meetings (Al-Anon is for the family, friends & lovers of someone who has an alcohol or drug problem)
– attend an open AA speaker meeting alone
– set clear rules & boundaries
– make sure that you have some time each week to spend with other family members (to take the focus off of your young adult that is using and to make sure that others have not been ignored)
make sure that you have some time each week for your own fun activities
– consider individual therapy for yourself

With treatment, young adults with a drug and/or alcohol problem can still reach their utmost potential. This gets harder and harder to do once your offspring hits their mid-20’s, 30’s or 40’s. Without treatment, your young adult’s drug and/or alcohol problem will get worse. There are many people in the United States that are paying the rent of their 30-something child and/or are raising their grandkids. To borrow a term from Charles Dickens, you can change your “ghost of Christmas future.” After reading this article, you can never say that you were not told.