Re: point counter-point <fwd>

[Guest guest]

This is from a post that appeared on APA Div 50. I will

later post my response to it on that forum, which I think

you might like to consider Apple for the aadeprogramming

site.

Pete

--- Begin Forwarded Message ---

======= Whilst the Big Book might be " psychological " (read " secular " )

it is also deeply spiritual/religious, making it truely " eclectic " . But,

for agnostic or atheistic listmembers, i would guess they don't have ears to

hear about the breadth of the eclecticism.

As I've argued elsewhere (see excerpts below), there are two groups called

Alcoholics Anonymous: group 1 is secular AA, and group 2 is

spiritual/religious AA. Please accept my apologies in advance for any

offense that is taken from what I've written below. My intent is to express

my opinion, not to upset anyone.

<snip>

I appreciate that most academically-based alcohol researchers and clinicians

are very deeply committed to the pre-theoretical assumptions or tacit beliefs

that provide

the invisible faith foundation for the reigning paradigm of reality in the

human sciences

known by some as philosophical materialism and others as logical positivism. As

a

consequence of these metatheoretical presuppositions, discussions about

transcendent

dimensions of reality, religiosity and spirituality instantly raise red flags of

suspicion and

distrust among many alcohol researchers embedded within academia. So be it.

I believe there are two branches of Alcoholics Anonymous: Authentic AA and

Pseudo-AA. The spiritually (religiously) based 12-step program described in the

Big Book (Alcoholics Anonymous, 1976) of Alcoholics Anonymous (AA) describes

authentic AA. As documented by AA historians Ernie Kurtz (1991, 1993), and

Dick B. (1997) recovering alcoholics who met at AA meetings in the 1940s

and 50s spent most of their time supporting each other in mutual attempts to

understand and practise the planned program of spiritual growth and

rediscovery embodied by the 12-steps. Unfortunately, 60 years

later, there is often quite a large schism between what happens in the

human fellowship component of AA on the one side (i.e., the meetings)

and the spiritual component (ie., 12-steps) on the other

side. Thus, in effect, there are currently two diverging branches of AA.

I have taken the liberty of labelling the first branch " authentic AA, " which

concerns itself primarily with using the planned program of recovery

(the 12-steps) as a vehicle for developing a relationship with a

God of ones understanding (or " Higher Power " ). In contrast, I refer to

the second branch as " pseudo AA, " because it concerns itself primarily

with fostering interpersonal relationships and human power. A suitable

synonym for this latter branch of AA might be secular AA.

Evidence there is a schism between these two branches is clearly visible

to anyone who any clean and sober recovering alcoholic who has attended a

reasonable number of AA meetings and who is involved in the planned

program of recovery embodied in the steps. Indeed, at least in the USA,

the schism has grown to such proportions thatspiritually and

religiously oriented AA members are increasingly banding together to

create an informal type of underground AA comprising of unofficial

home-based Big Book meetings centered on spiritual themes outlined

in the text Alcoholics Anonymous. Members of this secret

underground have not completely defected because they will often

attend official AA meetings in an effort to pass-on the core essential

message of AA, which is that human power alone (ie., " social support " )

is not an effective solution. Occasionally, these renegades will also

recruit people they meet at conventional AA meetings, usually AA

members whom they judge as showing a strong desire to grow in Spirit.

Given that their are really two AA programs, it is a misconception

to think that all, or even most, recovering alcoholics who attend AA

meetings sanctioned by Intergroup lists are necessarily concerned with

spiritual awakening through the 12-steps. Many, perhaps even

most AAs, are secular through and through. Obviously, the degree of

concern with achieving spiritual awakening differs for different individuals

and for groups in different geographic locations. This, however, does not

negate the observation that there are many agnostics and atheists

attending Intergroup sanctioned AA meetings: people whos chief

goal is to stay dry - on human power alone. Abstaining from alcohol

consumption is the overriding concern for this subgroup of secular AA

members, and they simply want nothing to do with God, Higher

Power or spiritual growth. By definition, these recovering alcoholics

do not adhere to the 12-step program of spiritual growth as documented

in conference approved AA literature.

It is possible that this failure to differentiate between authentic-AA

and pseudo-AA may have contributed to a widespread misconception

among university based alcohol researchers concerning the real purpose

of AA. Many scholars falsely believe that the outcome of prime

significance to the 12-steps of AA is physical sobriety. It is likely

that excessive concern with alcohol consumption as the primary outcome

of AA derives mostly from writings of agnostically-oriented Ph.D-level

researchers who naturally tend to dwell excessively upon pseudo (secular)

AA. This widespread neglect for non-drinking outcomes (eg.,

spiritual growth) appears to mirror the metatheoretical bias of this group

of investigators, a bias which favors philosophical materialism and logical

positivism. While physical abstinence is important, authentic AA

emphasizes the importance of achieving a deep and effective spiritual

experience that will revolutionize ones whole attitude toward life,

toward other people and toward Gods universe.

Thus, subscribers to this list should realize that one of the major

objectives for recovering alcoholics who practise the 12-steps is to

achieve a measure of spiritual awakening, which, according to the

Big Book, is considered the sufficient cause of both physical sobriety

and emotional sobriety. As expressed in the 12th step, emotional

sobriety is understood as consisting of the qualities of wisdom, joy

and altruism. These traits of character stand in stark contrast to the

dry drunk syndrome, in which the alcoholic is physically abstinent

from alcohol, but restless, irritable and discontented due to narcissistic

preoccupation with the selfish concerns.

[Guest guest]

This is my reply to the APADiv50 post:

--- Begin Forwarded Message ---

> > I have never ceased to be amazed at the number of psychological tools

> > incorporated in the AA Big Book. It is truely a pragmatic, eclectic,

> > work of psychological genius. Behaviorism, cognitive restructuring, family

> > systems theory, RET, etc, it is all there in that blue book ...

It has been said by a psychiatrist in AA that AA functions

like a Roscharch test, with ppl projecting things onto it

from their own mind; this appears to be an example of that

happening with the AA text. How one earth this view is

arrived at baffles me. Ellis, who devised RET, is no

advocate of religiosity aka spirituality. He has written an

essay " The Case against Religiosity. " Also, the 12-step

program is the very antithesis of cognitive-behavioral

approaches in many respects: CBT encourages internal

locus-of-control and a belief in personal self-efficacy and

an ability to overcome one's difficulties; the program

encourages one to believe one is personally powerless over

alcohol and the additional " ism " of alcoholism (whatever

that is), and to have external loci-of-control, God and

AA; CBT encourages ppl not to brood on their perceived

faults and failings, whereas the program encourages one to

make regular inventories of ones " defects of character " .

How on earth these vastly different paradigms can in any

case really be addressed in the 168 pages of the Big Book

main text (much of which is taken up with material like

" Bill's Story " ) escapes me.

>

>

> ======= Whilst the Big Book might be " psychological " (read " secular " )

> it is also deeply spiritual/religious, making it truly " eclectic " . But,

> for agnostic or atheistic listmembers, i would guess they don't have ears to

> hear about the breadth of the eclecticism.

This " ears to hear " expression matches the " eyes to see "

expression that was used in the full post that you

quote from above. Curious how apparently two separate

members of a supposedly non-religious fellowship should use

phrases derived from the New Testament to describe it,

which if you think about it, are rather reminiscent of

a similar claim that only wise ppl can see the Emperor's

new clothes. It does rather suggest that the Big Book is

considered a kind of Fifth Gospel, a phrase that was used

by the Oxford Group Movement from which AA emerged for the

divine guidance claimed by its members.

The passage below appears to also be a quote, from a source

you do not give. I have snipped it for brevity. I must say

it is remarkably revealing in that whereas in one important

aspect it is I believe inaccurate, it actually makes

starkly clear that the purpose of " authentic AA " is the

propagation of a " spiritual " i.e. religious belief system;

and that " using AA as a higher power " etc are *not* really

accepted as 'authentic' ways of practising the program; the

expectation is belief in some kind of God.

The inaccuracy is I believe that " secular AA " is not in

anything like the ascendant you describe. Certainly I have

seen no sign of that whatsoever in London, where I have

seen no discernable schism. you do of course, refer to

this happening in the US, but I have never heard any other

commentator on AA refer to such a schism either, and to me

the idea that " authentic AA " could ever be eclipsed in this

fashion in the Bible Belt of the US is completely

unthinkable. It is possible perhaps, that this may be

happening in the more cosmopolitan New York perhaps. One

might hope it would happen in radical California, but my

understanding is it isn't, with the ultra-conservative

Pacific Group AA still at the height of influence. If

anybody is being driven out, it is " secular AA " , with the

formation of SOS. SOS appears to basically

Atheist/Agnostic AA - if it were *really* possible to be

autonomous from other groups in AA, there would be no need

to form SOS, as supposedly in the Traditions " any two or

more ppl gathered together for the purpose of sobriety may

call themselves an AA group, so long as they have no other

affiliation. " This wording is again revealing, being a

paraphrase of [i quote from memory] " When two or more of you

are gathered together in my name I am among you " - or

something similar - again from the New Testament - all this

again, from an apparently non-Xtian, non-religious

organization.

It is often claimed that there is a " dry-drunk " syndrome

characterized by " narcissism " which is alleviated by

" working the program " . Even assuming it does in fact

achieve this, what abt the alcohol abuser who *isn't*

narcissistic? after all, if alcoholism is an " allergy " to

alcohol, biological in origin and potentially affecting

anyone, why should one need to be " narcissistic " to suffer

from it? And if not narcissistic, why should ppl

necessarily need the program? Many ppl with

alcohol/substance abuse disorders do indeed suffer from

Narcissistic Personality Disorder as defined in the DSM IV.

How genuine is in fact the apparent recovery from

narcissism? As well as being perturbed by the repeated use

of religious phraseology by AA-member clinicians in

professional forums like this one, I am also dismayed by

the flourishing of sobriety times sometimes seen as well,

with someone signing off after say, responding to a

challenge to the Disease Model of addiction with " Bill,

sober XX years " as some kind of bizarre display of status.

A religious sect like AA can provide a very fertile soil

for narcissism to grow; in AA as one of a privileged elite

with a " program " not shared by " civilians " ; as a Group

Secretary or Representative, or person with longest

sobriety time, or person with the most sponsees, or perhaps

person with the most spectacular drunkalogue.

In addition, many newcomers will have completely different

problems, such as Borderline Personality Disorder and many

Axis I complaints. But does AA encourage a newcomer to be

screened for coexisting disorders by a competent

professional? No it doesn't. Instead, they may be actively

discouraged from doing so, on the grounds that it may be

unnecessary or even dangerous, that " Many doctors don't

understand alcoholism " and " Xanax/Methadone is just

alcohol/heroin in pill/syrup form " and similar inaccurate

and potentially lethal advice to a severely ill person. An

AA newcomer has an excellent chance of never being

encouraged to look into anything but strictly physical

complaints arising from alcohol or drug abuse; there is

probably no other forum where so many ppl effectively try

to practice psychiatry without a license.

Pete Watts

[Guest guest]

Pete, your parodies of pompous pseudo-profundity are positively priceless!

This one had me howling. I don't think I've laughed so hard since the first

time I saw " Duck Soup! "

Please keep it up! More, more, I'm still not satisfied...

-- wally

PS: Are you going to give this character a name?

PPS: Maybe you could have him " write a book. " I've been amusing myself by

trying to think up titles... Like maybe " The Public Square and the Vienna

Circle " ... What do you think?

>...I appreciate that most academically-based alcohol researchers and

clinicians

>are very deeply committed to the pre-theoretical assumptions or tacit

beliefs that provide

> the invisible faith foundation for the reigning paradigm of reality in the

human sciences

>known by some as philosophical materialism and others as logical

positivism. As a

>consequence of these metatheoretical presuppositions, discussions about

transcendent

>dimensions of reality, religiosity and spirituality instantly raise red

flags of suspicion and

>distrust among many alcohol researchers embedded within academia. So be

it....

[Guest guest]

Hello Pete,

I know you did not write this with any expectations that this person

might get it but more for the other readers such as myself. You make

some very good counter points. I enjoyed it thoroughly. Bravo. Clap

clap....

pete watts wrote:

original article:/group/12-step-free/?start=8965

> My reply:

>

> --- Begin Forwarded Message ---

>

[Guest guest]

Hello Pete,

I know you did not write this with any expectations that this person

might get it but more for the other readers such as myself. You make

some very good counter points. I enjoyed it thoroughly. Bravo. Clap

clap....

pete watts wrote:

original article:/group/12-step-free/?start=8965

> My reply:

>

> --- Begin Forwarded Message ---

>

[Guest guest]

Hi ,

It is Tomodachi.

[Guest guest]

Hi ,

It is Tomodachi.

[Guest guest]

Hi ,

It is Tomodachi.

[Guest guest]

More of my replies to APA DIv 50:

--- Begin Forwarded Message ---

I will precede your comments with JS and mine with PW.

JS:

> While I realize that the following is anecdotal evidence I still believe it

> has some validity. In 1995 I attended the international AA convention in San

> Diego and saw nearly 80,000 sober people in (what was then called) Jack

> stadium. Now that, to me anyway, is some powerful proof that AA works.

ER wrote:

> > > It helps hopeless alcoholics get sober and

> > > become productive citizens at a higher success rate than anything all

> > the

> > > APA researchers have been able to come up with yet.

PW:

> > Could I have citations please? Because AA routinely refuses

> > to allow systematic investigation of it, there cannot

> > possibly be scientific justification for this claim. There

> > is however, some evidence it isn't true. By one of AA's own

> > triennial survey, only 5% of newcomers are still in AA at

> > the one year point, and 73% are still drinking. More ppl

> > recover spontaneously. Stanton Peele is of course a much

> > better authority than me on such matters. When I used these

> > statistics from AA's survey on addict-l, an AA practitioner

> > said that he would report back to the AA literature

> > committee that the statistics were being " misrepresented "

> > and they should not be made generally available anymore;

> > and from one report this appears to have happened.

JS:

> you always amaze me when you quote this particular survey. This was one

> of the most *unscientific* surveys known to mankind with many flaws in

> methodology. I can't right off hand think of anyone who would base a

> statement on the efficiency of a program on the basis of that survey. Yet you

> grasp it like a life preserver to prove your point

PW:

You are of course the AA practitioner who said he would

use his influence within AA to try to prevent such " misuse "

of these surveys. I don't know if you did try and how much

difference you made, but shortly afterward

epidemiologist Robin Room wrote that in his most recent

enquiry he had been no longer allowed access to the

survey data but could only obtain the officially released

AA documents on them. Robin Room is an epidemiologist of

repute; and he obviously considers this data of value, and

for some reason AA GSO now feels that they don't like an

independent scientist using them.

When there is no method of getting very high quality data

(and no Social Science data is ever perfect) then one must

use what is available; and as previously expressed, it is

considered valuable to an expert sociologist, Robin Room.

Also, I do not try to use it to " prove my point " as I said

before. What I actually said was " there is some evidence

that it [ER's] claim " isn't true. " In other word,

I was making quite a tentative comment based on it. In

contrast, you state of the AA 1995 convention that it was

" some powerful proof that AA works " - in other words, you

are claiming " powerful proof " for something that isn't even

a survey of any kind at all - just 80,000 ppl of a

fellowship with the order of a million US members and two

million worldwide - of ppl healthy enough and committed

enough to make a journey to the convention. Just how

small a crowd could be assembled and you consider it still

" powerful proof " ? Good grief, who is basing a viewpoint

on worse data, and a more extreme one to boot?

JS:

> and at the same time state

> that Project Match, which was a well designed research project, as being

> meaningless and useless. Isn't there a bit of a contradiction here?

PW:

I don't recall describing Match as meaningless and useless,

and doubt that I would use such extreme terms; in fact, I

have actually made some suggestions on the basis of it, and

as such therefore, cannot possibly have considered it

completely meaningless or useless. I acknowledge that

Principal Investigators Reid and Hester are extremely

eminent experts in the area of alcohol research. It is

ironic that my comments on Match have made references to

Reid and Hesters' *earlier* research, including that Match

produced precisely the results that one would have expected

from their earlier work, such as the lack of a " dosage

effect " for treatment - so, in the absence of any other

differences, one would expect 4 MET sessions to be as

effective as the 12 provided of CBT and TSF.

You state that it was a " well-designed research project " -

but have not referred to the methodological criticisms I

made of it. My 1500 word letter on the subject, which was

based on a less formal one I wrote to this list, was

considered worthy of being printed in the The Addictions

Newsletter. That would seem to suggest to that my arguments

were of scientific credibility, even if they were in fact

mistaken. That letter was followed by several in response,

also posted on this list, which were highly complimentary

of what I had written. Only critical response was included

by Bruce Liese in TAN - that by Fred Rotgers. Apart from

Fred's letter, *Nobody* has responded to my criticisms of

Match with a *scientific* argument as to why my criticisms

are invalid. Some have claimed that a control group could

not be included for ethical reasons - an invalid argument

as Duncan argued at the time, and in fact I consider

it unethical *not* to have included one, in that it would

have told us much more valuable information if it had.

Turning to Fred's objections, it is worth noting that Fred

is by no means uncritical of Match himself, but his

criticisms are based on its External Validity, while mine

are mostly on its Internal.

His response to me was essentially that Match wasn't

intended to demonstrate absolute or even relative treatment

efficacy but was to investigate the possible effectiveness

of matching patient characteristics to treatment

modalities. My response to this is that there is no point

in trying to find out the effectiveness of patient matching

in the absence of evidence that any of the modalities is

actually effective at all, and *that* could only be

demonstrated with a control group. [it is also worth

noting that Match is incessantly being used as supposedly

demonstrating both absolute and relative efficacy, which it

wasn't supposed to do. I have seem promotional material

from a 12-step rehab in the UK which includes an article

from a UK national newspaper claiming that Match showed

that " TSF is the best " - i.e a relative (and by implication

absolute) effectiveness claim. Similarly, I have seen

Match used to claim evidence for TSF effectiveness on the

basis of its overall performance comparability to CBT.]

To this it can be responded that there is already

supportive evidence for both MET and CBT in previous

studies, but I contend that that isn't good enough, in that

for robustness it is necessary to have one on every

occasion - not least here because the size and statistical

power of Match gave a splendid opportunity which ought not

to have been missed, especially with the lack of previous

experimental support for TSF. This belief is also

supported because of the problems of *External* Validity

that bother Fred. Even though previous studies might have

demonstrated effectiveness for MET and CBT, how could we be

sure these would be held up for the particular client

sample used in Match? One comment that Fred made was that

the " methodologically sophisticated " can construct

controls by comparing each treatment with the other two; to

which I respond: What happens when we do this? No treatment

is effective above control!

Finally, it is not of value just to find statistical

significance for a hypothesis; one needs a significant

effect size too. If it should transpire that the average IQ

of everyone called " S**** " is 1 point above the average of

everyone called " Watts " this would almost certainly be

massively statistically significant, and of scarcely any

practical significance at all. Certainly it would be of

precious little value in determining who was bringing

greater intelligence to bear on the present debate. While

effect sizes can be constructed from those apparently

statistically significant matching effects observed, what

use is this if we do not know what the effect size of the

treatments over control are? It is like trying to determine

whether an average IQ difference of 1 point is worth

bothering about without knowing what the standard deviation

of the IQ scale is.

JS:

> What I

> have seen in your writings is that anything that is negative about AA you

> accept as pure fact and anything that is positive about AA you discard as

> meaningless.

I do in fact apply a critical approach to negative

appraisals of AA, and do not discard supportive things as

automatically meaningless, but critique them in what I

consider to be an appropriate scientific manner.

JS:

> As for the horror stories on the 12 step free zone list and The news group

> Alt.recovery.from-12-steps, a while back I asked the person who is supposedly

> writing a book containing these so called horror stories what method she

> intended to use to verify the validity of these stories. She stated that she

> did not intend to verify them as the individuals had to be telling the true

> since they didn't like AA. You ask for citations about positive effects of

> AA but are willing to accept negative reports at face value. That to me is

> not a scientific approach.

J**, even assuming you report this author's response

accurately - it was THE AUTHOR's response, not mine. I

don't automatically accept negative reports at face value.

In fact, when one woman claimed to have been harassed by

AA members by various means, I made several posts asking

her how she knew that it was AA members who were doing

this, and I also considered the possibility

that she was suffering from a paranoid illness. But that

aside, I didn't suggest that the accounts of these

individuals automatically should be accepted as true. What I

am saying is that they are a source of discourses abt AA and

they are legitimate to exactly the same extent that the

positive discourses, including the 80,000 in that stadium

are. If you accept the stadium as evidence worthy of

consideration (with all the problems associated with

anecdotes), you should accept 12 step free stories as also

evidence *worthy of consideration* - no more than that. If

I am indeed biased, all you would have to do then would

simply invoke the evidence I neglect - simply *declaring*

me to be biased, even if true, does not by itself

demonstrate that I am.

I rather think the extremity of evidence selection and

conclusions drawn you see in me is actually what exists in

yourself, which careful comparison of your arguments and

mind reveals.

There is in fact one occasion where " anecdotal " evidence is

totally legitimate; that of the counterexample. A single

counter-example is all that is required to blow a universal

hypothesis out of the water.

Frequently, universal claims *are* made for AA. " No-one

will call you an alcoholic " , " One can be an atheist and

work the AA program " and " AA is compatible with anyone's

religious views " etc. etc. One does not need to " verify " a

committed Christian's or Jew's claim that they find AA

offensive to their religious views - if they say they are,

they are - and both of these have appeared on 12sf. It

might be a awhile before 12sf membership reaches 80,000 -

let alone two million, but it's growing.

Pete Watts

[Guest guest]

More of my replies to APA DIv 50:

--- Begin Forwarded Message ---

I will precede your comments with JS and mine with PW.

JS:

> While I realize that the following is anecdotal evidence I still believe it

> has some validity. In 1995 I attended the international AA convention in San

> Diego and saw nearly 80,000 sober people in (what was then called) Jack

> stadium. Now that, to me anyway, is some powerful proof that AA works.

ER wrote:

> > > It helps hopeless alcoholics get sober and

> > > become productive citizens at a higher success rate than anything all

> > the

> > > APA researchers have been able to come up with yet.

PW:

> > Could I have citations please? Because AA routinely refuses

> > to allow systematic investigation of it, there cannot

> > possibly be scientific justification for this claim. There

> > is however, some evidence it isn't true. By one of AA's own

> > triennial survey, only 5% of newcomers are still in AA at

> > the one year point, and 73% are still drinking. More ppl

> > recover spontaneously. Stanton Peele is of course a much

> > better authority than me on such matters. When I used these

> > statistics from AA's survey on addict-l, an AA practitioner

> > said that he would report back to the AA literature

> > committee that the statistics were being " misrepresented "

> > and they should not be made generally available anymore;

> > and from one report this appears to have happened.

JS:

> you always amaze me when you quote this particular survey. This was one

> of the most *unscientific* surveys known to mankind with many flaws in

> methodology. I can't right off hand think of anyone who would base a

> statement on the efficiency of a program on the basis of that survey. Yet you

> grasp it like a life preserver to prove your point

PW:

You are of course the AA practitioner who said he would

use his influence within AA to try to prevent such " misuse "

of these surveys. I don't know if you did try and how much

difference you made, but shortly afterward

epidemiologist Robin Room wrote that in his most recent

enquiry he had been no longer allowed access to the

survey data but could only obtain the officially released

AA documents on them. Robin Room is an epidemiologist of

repute; and he obviously considers this data of value, and

for some reason AA GSO now feels that they don't like an

independent scientist using them.

When there is no method of getting very high quality data

(and no Social Science data is ever perfect) then one must

use what is available; and as previously expressed, it is

considered valuable to an expert sociologist, Robin Room.

Also, I do not try to use it to " prove my point " as I said

before. What I actually said was " there is some evidence

that it [ER's] claim " isn't true. " In other word,

I was making quite a tentative comment based on it. In

contrast, you state of the AA 1995 convention that it was

" some powerful proof that AA works " - in other words, you

are claiming " powerful proof " for something that isn't even

a survey of any kind at all - just 80,000 ppl of a

fellowship with the order of a million US members and two

million worldwide - of ppl healthy enough and committed

enough to make a journey to the convention. Just how

small a crowd could be assembled and you consider it still

" powerful proof " ? Good grief, who is basing a viewpoint

on worse data, and a more extreme one to boot?

JS:

> and at the same time state

> that Project Match, which was a well designed research project, as being

> meaningless and useless. Isn't there a bit of a contradiction here?

PW:

I don't recall describing Match as meaningless and useless,

and doubt that I would use such extreme terms; in fact, I

have actually made some suggestions on the basis of it, and

as such therefore, cannot possibly have considered it

completely meaningless or useless. I acknowledge that

Principal Investigators Reid and Hester are extremely

eminent experts in the area of alcohol research. It is

ironic that my comments on Match have made references to

Reid and Hesters' *earlier* research, including that Match

produced precisely the results that one would have expected

from their earlier work, such as the lack of a " dosage

effect " for treatment - so, in the absence of any other

differences, one would expect 4 MET sessions to be as

effective as the 12 provided of CBT and TSF.

You state that it was a " well-designed research project " -

but have not referred to the methodological criticisms I

made of it. My 1500 word letter on the subject, which was

based on a less formal one I wrote to this list, was

considered worthy of being printed in the The Addictions

Newsletter. That would seem to suggest to that my arguments

were of scientific credibility, even if they were in fact

mistaken. That letter was followed by several in response,

also posted on this list, which were highly complimentary

of what I had written. Only critical response was included

by Bruce Liese in TAN - that by Fred Rotgers. Apart from

Fred's letter, *Nobody* has responded to my criticisms of

Match with a *scientific* argument as to why my criticisms

are invalid. Some have claimed that a control group could

not be included for ethical reasons - an invalid argument

as Duncan argued at the time, and in fact I consider

it unethical *not* to have included one, in that it would

have told us much more valuable information if it had.

Turning to Fred's objections, it is worth noting that Fred

is by no means uncritical of Match himself, but his

criticisms are based on its External Validity, while mine

are mostly on its Internal.

His response to me was essentially that Match wasn't

intended to demonstrate absolute or even relative treatment

efficacy but was to investigate the possible effectiveness

of matching patient characteristics to treatment

modalities. My response to this is that there is no point

in trying to find out the effectiveness of patient matching

in the absence of evidence that any of the modalities is

actually effective at all, and *that* could only be

demonstrated with a control group. [it is also worth

noting that Match is incessantly being used as supposedly

demonstrating both absolute and relative efficacy, which it

wasn't supposed to do. I have seem promotional material

from a 12-step rehab in the UK which includes an article

from a UK national newspaper claiming that Match showed

that " TSF is the best " - i.e a relative (and by implication

absolute) effectiveness claim. Similarly, I have seen

Match used to claim evidence for TSF effectiveness on the

basis of its overall performance comparability to CBT.]

To this it can be responded that there is already

supportive evidence for both MET and CBT in previous

studies, but I contend that that isn't good enough, in that

for robustness it is necessary to have one on every

occasion - not least here because the size and statistical

power of Match gave a splendid opportunity which ought not

to have been missed, especially with the lack of previous

experimental support for TSF. This belief is also

supported because of the problems of *External* Validity

that bother Fred. Even though previous studies might have

demonstrated effectiveness for MET and CBT, how could we be

sure these would be held up for the particular client

sample used in Match? One comment that Fred made was that

the " methodologically sophisticated " can construct

controls by comparing each treatment with the other two; to

which I respond: What happens when we do this? No treatment

is effective above control!

Finally, it is not of value just to find statistical

significance for a hypothesis; one needs a significant

effect size too. If it should transpire that the average IQ

of everyone called " S**** " is 1 point above the average of

everyone called " Watts " this would almost certainly be

massively statistically significant, and of scarcely any

practical significance at all. Certainly it would be of

precious little value in determining who was bringing

greater intelligence to bear on the present debate. While

effect sizes can be constructed from those apparently

statistically significant matching effects observed, what

use is this if we do not know what the effect size of the

treatments over control are? It is like trying to determine

whether an average IQ difference of 1 point is worth

bothering about without knowing what the standard deviation

of the IQ scale is.

JS:

> What I

> have seen in your writings is that anything that is negative about AA you

> accept as pure fact and anything that is positive about AA you discard as

> meaningless.

I do in fact apply a critical approach to negative

appraisals of AA, and do not discard supportive things as

automatically meaningless, but critique them in what I

consider to be an appropriate scientific manner.

JS:

> As for the horror stories on the 12 step free zone list and The news group

> Alt.recovery.from-12-steps, a while back I asked the person who is supposedly

> writing a book containing these so called horror stories what method she

> intended to use to verify the validity of these stories. She stated that she

> did not intend to verify them as the individuals had to be telling the true

> since they didn't like AA. You ask for citations about positive effects of

> AA but are willing to accept negative reports at face value. That to me is

> not a scientific approach.

J**, even assuming you report this author's response

accurately - it was THE AUTHOR's response, not mine. I

don't automatically accept negative reports at face value.

In fact, when one woman claimed to have been harassed by

AA members by various means, I made several posts asking

her how she knew that it was AA members who were doing

this, and I also considered the possibility

that she was suffering from a paranoid illness. But that

aside, I didn't suggest that the accounts of these

individuals automatically should be accepted as true. What I

am saying is that they are a source of discourses abt AA and

they are legitimate to exactly the same extent that the

positive discourses, including the 80,000 in that stadium

are. If you accept the stadium as evidence worthy of

consideration (with all the problems associated with

anecdotes), you should accept 12 step free stories as also

evidence *worthy of consideration* - no more than that. If

I am indeed biased, all you would have to do then would

simply invoke the evidence I neglect - simply *declaring*

me to be biased, even if true, does not by itself

demonstrate that I am.

I rather think the extremity of evidence selection and

conclusions drawn you see in me is actually what exists in

yourself, which careful comparison of your arguments and

mind reveals.

There is in fact one occasion where " anecdotal " evidence is

totally legitimate; that of the counterexample. A single

counter-example is all that is required to blow a universal

hypothesis out of the water.

Frequently, universal claims *are* made for AA. " No-one

will call you an alcoholic " , " One can be an atheist and

work the AA program " and " AA is compatible with anyone's

religious views " etc. etc. One does not need to " verify " a

committed Christian's or Jew's claim that they find AA

offensive to their religious views - if they say they are,

they are - and both of these have appeared on 12sf. It

might be a awhile before 12sf membership reaches 80,000 -

let alone two million, but it's growing.

Pete Watts

[Guest guest]

Shirk is an asshole. I thought it was really funny when he started

bringing that shit up about 's book on usenet and another list.

He had a real problem with them not checking out the stories and he even

intimated that AA would sue. Too bad he doesn't hold the big book up to

such standards. Did they investigate the stories in the back of the big

book prior to publishing them? How do I sign up for Div 50, Pete?

Pete Watts wrote:

>

> More of my replies to APA DIv 50:

>

> --- Begin Forwarded Message ---

>

> I will precede your comments with JS and mine with PW.

>

> JS:

> > While I realize that the following is anecdotal evidence I still believe it

> > has some validity. In 1995 I attended the international AA convention in San

> > Diego and saw nearly 80,000 sober people in (what was then called) Jack

> > stadium. Now that, to me anyway, is some powerful proof that AA

works.

>

> ER wrote:

>

> > > > It helps hopeless alcoholics get sober and

> > > > become productive citizens at a higher success rate than anything all

> > > the

> > > > APA researchers have been able to come up with yet.

>

> PW:

> > > Could I have citations please? Because AA routinely refuses

> > > to allow systematic investigation of it, there cannot

> > > possibly be scientific justification for this claim. There

> > > is however, some evidence it isn't true. By one of AA's own

> > > triennial survey, only 5% of newcomers are still in AA at

> > > the one year point, and 73% are still drinking. More ppl

> > > recover spontaneously. Stanton Peele is of course a much

> > > better authority than me on such matters. When I used these

> > > statistics from AA's survey on addict-l, an AA practitioner

> > > said that he would report back to the AA literature

> > > committee that the statistics were being " misrepresented "

> > > and they should not be made generally available anymore;

> > > and from one report this appears to have happened.

>

> JS:

> > you always amaze me when you quote this particular survey. This was

one

> > of the most *unscientific* surveys known to mankind with many flaws in

> > methodology. I can't right off hand think of anyone who would base a

> > statement on the efficiency of a program on the basis of that survey. Yet

you

> > grasp it like a life preserver to prove your point

>

> PW:

>

> You are of course the AA practitioner who said he would

> use his influence within AA to try to prevent such " misuse "

> of these surveys. I don't know if you did try and how much

> difference you made, but shortly afterward

> epidemiologist Robin Room wrote that in his most recent

> enquiry he had been no longer allowed access to the

> survey data but could only obtain the officially released

> AA documents on them. Robin Room is an epidemiologist of

> repute; and he obviously considers this data of value, and

> for some reason AA GSO now feels that they don't like an

> independent scientist using them.

>

> When there is no method of getting very high quality data

> (and no Social Science data is ever perfect) then one must

> use what is available; and as previously expressed, it is

> considered valuable to an expert sociologist, Robin Room.

>

> Also, I do not try to use it to " prove my point " as I said

> before. What I actually said was " there is some evidence

> that it [ER's] claim " isn't true. " In other word,

> I was making quite a tentative comment based on it. In

> contrast, you state of the AA 1995 convention that it was

> " some powerful proof that AA works " - in other words, you

> are claiming " powerful proof " for something that isn't even

> a survey of any kind at all - just 80,000 ppl of a

> fellowship with the order of a million US members and two

> million worldwide - of ppl healthy enough and committed

> enough to make a journey to the convention. Just how

> small a crowd could be assembled and you consider it still

> " powerful proof " ? Good grief, who is basing a viewpoint

> on worse data, and a more extreme one to boot?

>

> JS:

> > and at the same time state

> > that Project Match, which was a well designed research project, as being

> > meaningless and useless. Isn't there a bit of a contradiction here?

>

> PW:

> I don't recall describing Match as meaningless and useless,

> and doubt that I would use such extreme terms; in fact, I

> have actually made some suggestions on the basis of it, and

> as such therefore, cannot possibly have considered it

> completely meaningless or useless. I acknowledge that

> Principal Investigators Reid and Hester are extremely

> eminent experts in the area of alcohol research. It is

> ironic that my comments on Match have made references to

> Reid and Hesters' *earlier* research, including that Match

> produced precisely the results that one would have expected

> from their earlier work, such as the lack of a " dosage

> effect " for treatment - so, in the absence of any other

> differences, one would expect 4 MET sessions to be as

> effective as the 12 provided of CBT and TSF.

>

> You state that it was a " well-designed research project " -

> but have not referred to the methodological criticisms I

> made of it. My 1500 word letter on the subject, which was

> based on a less formal one I wrote to this list, was

> considered worthy of being printed in the The Addictions

> Newsletter. That would seem to suggest to that my arguments

> were of scientific credibility, even if they were in fact

> mistaken. That letter was followed by several in response,

> also posted on this list, which were highly complimentary

> of what I had written. Only critical response was included

> by Bruce Liese in TAN - that by Fred Rotgers. Apart from

> Fred's letter, *Nobody* has responded to my criticisms of

> Match with a *scientific* argument as to why my criticisms

> are invalid. Some have claimed that a control group could

> not be included for ethical reasons - an invalid argument

> as Duncan argued at the time, and in fact I consider

> it unethical *not* to have included one, in that it would

> have told us much more valuable information if it had.

>

> Turning to Fred's objections, it is worth noting that Fred

> is by no means uncritical of Match himself, but his

> criticisms are based on its External Validity, while mine

> are mostly on its Internal.

>

> His response to me was essentially that Match wasn't

> intended to demonstrate absolute or even relative treatment

> efficacy but was to investigate the possible effectiveness

> of matching patient characteristics to treatment

> modalities. My response to this is that there is no point

> in trying to find out the effectiveness of patient matching

> in the absence of evidence that any of the modalities is

> actually effective at all, and *that* could only be

> demonstrated with a control group. [it is also worth

> noting that Match is incessantly being used as supposedly

> demonstrating both absolute and relative efficacy, which it

> wasn't supposed to do. I have seem promotional material

> from a 12-step rehab in the UK which includes an article

> from a UK national newspaper claiming that Match showed

> that " TSF is the best " - i.e a relative (and by implication

> absolute) effectiveness claim. Similarly, I have seen

> Match used to claim evidence for TSF effectiveness on the

> basis of its overall performance comparability to CBT.]

> To this it can be responded that there is already

> supportive evidence for both MET and CBT in previous

> studies, but I contend that that isn't good enough, in that

> for robustness it is necessary to have one on every

> occasion - not least here because the size and statistical

> power of Match gave a splendid opportunity which ought not

> to have been missed, especially with the lack of previous

> experimental support for TSF. This belief is also

> supported because of the problems of *External* Validity

> that bother Fred. Even though previous studies might have

> demonstrated effectiveness for MET and CBT, how could we be

> sure these would be held up for the particular client

> sample used in Match? One comment that Fred made was that

> the " methodologically sophisticated " can construct

> controls by comparing each treatment with the other two; to

> which I respond: What happens when we do this? No treatment

> is effective above control!

>

> Finally, it is not of value just to find statistical

> significance for a hypothesis; one needs a significant

> effect size too. If it should transpire that the average IQ

> of everyone called " S**** " is 1 point above the average of

> everyone called " Watts " this would almost certainly be

> massively statistically significant, and of scarcely any

> practical significance at all. Certainly it would be of

> precious little value in determining who was bringing

> greater intelligence to bear on the present debate. While

> effect sizes can be constructed from those apparently

> statistically significant matching effects observed, what

> use is this if we do not know what the effect size of the

> treatments over control are? It is like trying to determine

> whether an average IQ difference of 1 point is worth

> bothering about without knowing what the standard deviation

> of the IQ scale is.

>

> JS:

> > What I

> > have seen in your writings is that anything that is negative about AA you

> > accept as pure fact and anything that is positive about AA you discard as

> > meaningless.

>

> I do in fact apply a critical approach to negative

> appraisals of AA, and do not discard supportive things as

> automatically meaningless, but critique them in what I

> consider to be an appropriate scientific manner.

>

> JS:

> > As for the horror stories on the 12 step free zone list and The news group

> > Alt.recovery.from-12-steps, a while back I asked the person who is

supposedly

> > writing a book containing these so called horror stories what method she

> > intended to use to verify the validity of these stories. She stated that she

> > did not intend to verify them as the individuals had to be telling the true

> > since they didn't like AA. You ask for citations about positive effects of

> > AA but are willing to accept negative reports at face value. That to me is

> > not a scientific approach.

>

> J**, even assuming you report this author's response

> accurately - it was THE AUTHOR's response, not mine. I

> don't automatically accept negative reports at face value.

> In fact, when one woman claimed to have been harassed by

> AA members by various means, I made several posts asking

> her how she knew that it was AA members who were doing

> this, and I also considered the possibility

> that she was suffering from a paranoid illness. But that

> aside, I didn't suggest that the accounts of these

> individuals automatically should be accepted as true. What I

> am saying is that they are a source of discourses abt AA and

> they are legitimate to exactly the same extent that the

> positive discourses, including the 80,000 in that stadium

> are. If you accept the stadium as evidence worthy of

> consideration (with all the problems associated with

> anecdotes), you should accept 12 step free stories as also

> evidence *worthy of consideration* - no more than that. If

> I am indeed biased, all you would have to do then would

> simply invoke the evidence I neglect - simply *declaring*

> me to be biased, even if true, does not by itself

> demonstrate that I am.

>

> I rather think the extremity of evidence selection and

> conclusions drawn you see in me is actually what exists in

> yourself, which careful comparison of your arguments and

> mind reveals.

>

> There is in fact one occasion where " anecdotal " evidence is

> totally legitimate; that of the counterexample. A single

> counter-example is all that is required to blow a universal

> hypothesis out of the water.

>

> Frequently, universal claims *are* made for AA. " No-one

> will call you an alcoholic " , " One can be an atheist and

> work the AA program " and " AA is compatible with anyone's

> religious views " etc. etc. One does not need to " verify " a

> committed Christian's or Jew's claim that they find AA

> offensive to their religious views - if they say they are,

> they are - and both of these have appeared on 12sf. It

> might be a awhile before 12sf membership reaches 80,000 -

> let alone two million, but it's growing.

>

> Pete Watts

>

> ------------------------------------------------------------------------

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