Re: The Nocebo Effect of Alcoholics Anonymous

[Guest guest]

The Nocebo Effect of Alcoholics Anonymous

After a short time in AA I began to see an obvious placebo affect at work in the program. You go to a meeting and twenty people tell you that you won’t need to drink today because, and only because you’ve been to an AA meeting. You look to the woman on your left, and she nods. You look to the man on your right, and he nods too. So you think to yourself, “Cool. I guess I don’t have to drink today.” This is without having worked a step, before getting a sponsor, before doing service or twelfth step work. In subsequent meetings the group tells you that doing all these things will bring you even further away from that next drink. The man and woman nod again.

A placebo is something that is given to satisfy someone who believes it to be a treatment, or in this case, a solution to one’s drinking problem. AA has a fairly elaborate, time consuming, and lifelong set of instructions on how to stay sober that serve this purpose. Go to 90 meetings in 90 days, then 3-5 meetings a week. Work the 12 steps. Call your sponsor. Do service work. Read the book. Work with newcomers. And looming over it all is the belief that God will relieve you of the desire to drink - if you do these things. So one day at a time AA’s do what they believe will keep them sober and many do stay sober. (Is this not the idea behind “Fake it until you make it?”) I lived for years knowing this, having only a few problems with it because I believed everyone had their problems that needed to be faced, that this was mine, and AA was a small price to pay to avoid the alternative.

I honestly believed for a time that the alternative to working the AA program was jails, institutions, and/or death; that if I stopped going to meetings, working the program, or had I not joined AA in the first place, serious consequences would have followed. Of course AA literature allows that alcoholics have been known to stay sober without AA, but I think the Big Book describes these cases as “comparatively rare.” Except for the fairly common stories of alcoholics who manage to “white knuckle” their way through life in their hellish existence without AA I’ve never seen a group show the slightest hope of this happening, so I think it’s safe to say that AA believes this in theory only. In practice Alcoholics Anonymous believes an individual is screwed unless they work the program, and even then the general opinion is that a lot of them will die drunk anyway. Look at the whole picture. A roomful of people tell you that they’re your best friend, only they can understand your problem, and that if you are indeed an alcoholic, your only hope is AA, and nobody gets to AA by mistake, right? They say you should take what you want and leave the rest but then they also say it’s suggested you work the program like it’s suggested you wear a parachute if you jump out of an airplane. This and more helps create the opposite of a placebo effect, namely the Nocebo Effect of Alcoholics Anonymous. The action of not doing what is suggested by AA causes a return to drinking.

One day at a time, 3-5 times a week AA members hear over and over and over again how they will slip back into the old life if they don’t attend meetings or stop working the program. “Meeting makers make it,” and “If you don’t go to meetings, you aren’t here to see what happens to people who don’t go to meetings,” are only a few phrases that create this self-fulfilling prophecy. At the very least members hear that missing a few meetings causes an alcoholic to become testy and “squirrel cage,” because they’re not getting what they need to remain mentally balanced, their medicine as it were. This implies, of course, that further missed meetings will result in the ultimate mental imbalance for an AA – the next drink. Slogans such as “If you don’t work a fourth you’ll drink a fifth,” show further the mindset in AA that a member who fails to work the program by certain guidelines is destined to drink.

What gives even more power to the nocebo effect in Alcoholics Anonymous is the awesome and unnecessary power members continue to give alcohol. A person who considers their life. One would think that the first goal of a person looking to attain abstinence would be to stop giving alcohol all that power. In AA the opposite happens. New members are offered a conception of alcohol as “cunning, baffling, and powerful…and patient.” It’s not that last drunk or all the other drinks that makes a person an alcoholic, according to many. To them, what makes a person an alcoholic is the fact that somewhere out there is that next drink with their name on it, over which they have no worldly power, and only through the Big Book, sponsorship, and the fellowship of Alcoholics Anonymous can a person stay sober. And even then it can be done only for today!

What has happened is that in order to keep its members from the bottle, Alcoholic Anonymous has created for themselves a certain alcoholism-induced reality that lives not only in the meeting rooms, but has found its way into treatment centers, courtrooms, and most other places problem drinkers might find themselves or turn for help. You don’t even have to go to an AA meeting to be told that you can’t stay sober without AA. (Because if you could stay sober without AA you wouldn’t have to ask for help, right?) Even if they don’t like the program or attend AA meetings, people buy into its definition of their problem and it hurts them. AA’s Boogeyman worldview of alcoholism where that darn alcohol is gonna get you if you don’t work with a Higher Power and do what AA says doesn’t appeal to everyone. Unfortunately, many do keep the idea of the Boogeyman, and when they can’t or won’t join AA for any number of very good reasons or choose to leave the program behind them, the Nocebo Effect of Alcoholics Anonymous is one very large factor of those who become AA’s evidence of the need to attend meetings. As always, those who do fine without AA are not talked about.

[Guest guest]

>

> Nate, are you the author of this? Will you be posting it on your site, coz if

not, I'd love to post it.

It's a good piece!

Apple

>

>

> The Nocebo Effect of Alcoholics Anonymous

>

> After a short time in AA I began to see an obvious placebo affect

at work in the program. You go to a meeting and twenty people tell you that you

won't need to drink today because, and only because you've been to an AA

meeting. You look to the woman on your left, and she nods. You look to the man

on your right, and he nods too. So you think to yourself, " Cool. I guess I

don't have to drink today. " This is without having worked a step, before

getting a sponsor, before doing service or twelfth step work. In subsequent

meetings the group tells you that doing all these things will bring you even

further away from that next drink. The man and woman nod again.

>

> A placebo is something that is given to satisfy someone who

believes it to be a treatment, or in this case, a solution to one's drinking

problem. AA has a fairly elaborate, time consuming, and lifelong set of

instructions on how to stay sober that serve this purpose. Go to 90 meetings in

90 days, then 3-5 meetings a week. Work the 12 steps. Call your sponsor. Do

service work. Read the book. Work with newcomers. And looming over it all is

the belief that God will relieve you of the desire to drink - if you do these

things. So one day at a time AA's do what they believe will keep them sober and

many do stay sober. (Is this not the idea behind " Fake it until you make it? " )

I lived for years knowing this, having only a few problems with it because I

believed everyone had their problems that needed to be faced, that this was

mine, and AA was a small price to pay to avoid the alternative.

>

> I honestly believed for a time that the alternative to working the

AA program was jails, institutions, and/or death; that if I stopped going to

meetings, working the program, or had I not joined AA in the first place,

serious consequences would have followed. Of course AA literature allows that

alcoholics have been known to stay sober without AA, but I think the Big Book

describes these cases as " comparatively rare. " Except for the fairly common

stories of alcoholics who manage to " white knuckle " their way through life in

their hellish existence without AA I've never seen a group show the slightest

hope of this happening, so I think it's safe to say that AA believes this in

theory only. In practice Alcoholics Anonymous believes an individual is screwed

unless they work the program, and even then the general opinion is that a lot of

them will die drunk anyway. Look at the whole picture. A roomful of people

tell you that they're your best friend, only they can understand your problem,

and that if you are indeed an alcoholic, your only hope is AA, and nobody gets

to AA by mistake, right? They say you should take what you want and leave the

rest but then they also say it's suggested you work the program like it's

suggested you wear a parachute if you jump out of an airplane. This and more

helps create the opposite of a placebo effect, namely the Nocebo Effect of

Alcoholics Anonymous. The action of not doing what is suggested by AA causes a

return to drinking.

>

> One day at a time, 3-5 times a week AA members hear over and over

and over again how they will slip back into the old life if they don't attend

meetings or stop working the program. " Meeting makers make it, " and " If you

don't go to meetings, you aren't here to see what happens to people who don't go

to meetings, " are only a few phrases that create this self-fulfilling prophecy.

At the very least members hear that missing a few meetings causes an alcoholic

to become testy and " squirrel cage, " because they're not getting what they need

to remain mentally balanced, their medicine as it were. This implies, of

course, that further missed meetings will result in the ultimate mental

imbalance for an AA - the next drink. Slogans such as " If you don't work a

fourth you'll drink a fifth, " show further the mindset in AA that a member who

fails to work the program by certain guidelines is destined to drink.

>

> What gives even more power to the nocebo effect in Alcoholics

Anonymous is the awesome and unnecessary power members continue to give alcohol.

A person who considers their life. One would think that the first goal of a

person looking to attain abstinence would be to stop giving alcohol all that

power. In AA the opposite happens. New members are offered a conception of

alcohol as " cunning, baffling, and powerful.and patient. " It's not that last

drunk or all the other drinks that makes a person an alcoholic, according to

many. To them, what makes a person an alcoholic is the fact that somewhere out

there is that next drink with their name on it, over which they have no worldly

power, and only through the Big Book, sponsorship, and the fellowship of

Alcoholics Anonymous can a person stay sober. And even then it can be done only

for today!

>

> What has happened is that in order to keep its members from the bottle,

Alcoholic Anonymous has created for themselves a certain alcoholism-induced

reality that lives not only in the meeting rooms, but has found its way into

treatment centers, courtrooms, and most other places problem drinkers might find

themselves or turn for help. You don't even have to go to an AA meeting to be

told that you can't stay sober without AA. (Because if you could stay sober

without AA you wouldn't have to ask for help, right?)

>

> Even if they don't like the program or attend AA meetings, people

buy into its definition of their problem and it hurts them. AA's Boogeyman

worldview of alcoholism where that darn alcohol is gonna get you if you don't

work with a Higher Power and do what AA says doesn't appeal to everyone.

Unfortunately, many do keep the idea of the Boogeyman, and when they can't or

won't join AA for any number of very good reasons or choose to leave the program

behind them, the Nocebo Effect of Alcoholics Anonymous is one very large factor

of those who become AA's evidence of the need to attend meetings. As always,

those who do fine without AA are not talked about.

[Guest guest]

nate, i agree. i thin you should post a copy of this in the 12-step

free files. btw, what was url for your site?

> >

> > Nate, are you the author of this? Will you be posting it on

your site, coz if not, I'd love to post it.

> It's a good piece!

> Apple

> >

> >

> > The Nocebo Effect of Alcoholics Anonymous

> >

> > After a short time in AA I began to see an obvious

placebo affect at work in the program. You go to a meeting and

twenty people tell you that you won't need to drink today because,

and only because you've been to an AA meeting. You look to the

woman on your left, and she nods. You look to the man on your

right, and he nods too. So you think to yourself, " Cool. I guess I

don't have to drink today. " This is without having worked a step,

before getting a sponsor, before doing service or twelfth step

work. In subsequent meetings the group tells you that doing all

these things will bring you even further away from that next drink.

The man and woman nod again.

> >

> > A placebo is something that is given to satisfy

someone who believes it to be a treatment, or in this case, a

solution to one's drinking problem. AA has a fairly elaborate,

time consuming, and lifelong set of instructions on how to stay

sober that serve this purpose. Go to 90 meetings in 90 days,

then 3-5 meetings a week. Work the 12 steps. Call your

sponsor. Do service work. Read the book. Work with

newcomers. And looming over it all is the belief that God will

relieve you of the desire to drink - if you do these things. So one

day at a time AA's do what they believe will keep them sober and

many do stay sober. (Is this not the idea behind " Fake it until you

make it? " ) I lived for years knowing this, having only a few

problems with it because I believed everyone had their problems

that needed to be faced, that this was mine, and AA was a small

price to pay to avoid the alternative.

> >

> > I honestly believed for a time that the alternative to

working the AA program was jails, institutions, and/or death; that

if I stopped going to meetings, working the program, or had I not

joined AA in the first place, serious consequences would have

followed. Of course AA literature allows that alcoholics have

been known to stay sober without AA, but I think the Big Book

describes these cases as " comparatively rare. " Except for the

fairly common stories of alcoholics who manage to " white

knuckle " their way through life in their hellish existence without

AA I've never seen a group show the slightest hope of this

happening, so I think it's safe to say that AA believes this in

theory only. In practice Alcoholics Anonymous believes an

individual is screwed unless they work the program, and even

then the general opinion is that a lot of them will die drunk

anyway. Look at the whole picture. A roomful of people tell you

that they're your best friend, only they can understand your

problem, and that if you are indeed an alcoholic, your only hope

is AA, and nobody gets to AA by mistake, right? They say you

should take what you want and leave the rest but then they also

say it's suggested you work the program like it's suggested you

wear a parachute if you jump out of an airplane. This and more

helps create the opposite of a placebo effect, namely the Nocebo

Effect of Alcoholics Anonymous. The action of not doing what is

suggested by AA causes a return to drinking.

> >

> > One day at a time, 3-5 times a week AA members hear

over and over and over again how they will slip back into the old

life if they don't attend meetings or stop working the program.

" Meeting makers make it, " and " If you don't go to meetings, you

aren't here to see what happens to people who don't go to

meetings, " are only a few phrases that create this self-fulfilling

prophecy. At the very least members hear that missing a few

meetings causes an alcoholic to become testy and " squirrel

cage, " because they're not getting what they need to remain

mentally balanced, their medicine as it were. This implies, of

course, that further missed meetings will result in the ultimate

mental imbalance for an AA - the next drink. Slogans such as " If

you don't work a fourth you'll drink a fifth, " show further the

mindset in AA that a member who fails to work the program by

certain guidelines is destined to drink.

> >

> > What gives even more power to the nocebo effect in

Alcoholics Anonymous is the awesome and unnecessary power

members continue to give alcohol. A person who considers

their life. One would think that the first goal of a person looking

to attain abstinence would be to stop giving alcohol all that

power. In AA the opposite happens. New members are offered

a conception of alcohol as " cunning, baffling, and powerful.and

patient. " It's not that last drunk or all the other drinks that makes

a person an alcoholic, according to many. To them, what makes

a person an alcoholic is the fact that somewhere out there is that

next drink with their name on it, over which they have no worldly

power, and only through the Big Book, sponsorship, and the

fellowship of Alcoholics Anonymous can a person stay sober.

And even then it can be done only for today!

> >

> > What has happened is that in order to keep its members

from the bottle, Alcoholic Anonymous has created for themselves

a certain alcoholism-induced reality that lives not only in the

meeting rooms, but has found its way into treatment centers,

courtrooms, and most other places problem drinkers might find

themselves or turn for help. You don't even have to go to an AA

meeting to be told that you can't stay sober without AA. (Because

if you could stay sober without AA you wouldn't have to ask for

help, right?)

> >

> > Even if they don't like the program or attend AA

meetings, people buy into its definition of their problem and it

hurts them. AA's Boogeyman worldview of alcoholism where

that darn alcohol is gonna get you if you don't work with a Higher

Power and do what AA says doesn't appeal to everyone.

Unfortunately, many do keep the idea of the Boogeyman, and

when they can't or won't join AA for any number of very good

reasons or choose to leave the program behind them, the

Nocebo Effect of Alcoholics Anonymous is one very large factor

of those who become AA's evidence of the need to attend

meetings. As always, those who do fine without AA are not

talked about.

[Guest guest]

>

Nate,

Nice write-up. Really hit home for me and my experience with AA. What

you write is exactly my interpretation of AA during my membership. I

believe thats how most AA's experience it although if you argue with

an AA he/she will tell you thats not exactly how it is. Although we

know otherwise.

Pat

>

>

> The Nocebo Effect of Alcoholics Anonymous

>

> After a short time in AA I began to see an obvious

placebo affect at work in the program. You go to a meeting and twenty

people tell you that you won't need to drink today because, and only

because you've been to an AA meeting. You look to the woman on your

left, and she nods. You look to the man on your right, and he nods

too. So you think to yourself, " Cool. I guess I don't have to drink

today. " This is without having worked a step, before getting a

sponsor, before doing service or twelfth step work. In subsequent

meetings the group tells you that doing all these things will bring

you even further away from that next drink. The man and woman nod

again.

>

> A placebo is something that is given to satisfy someone

who believes it to be a treatment, or in this case, a solution to

one's drinking problem. AA has a fairly elaborate, time consuming,

and lifelong set of instructions on how to stay sober that serve this

purpose. Go to 90 meetings in 90 days, then 3-5 meetings a week.

Work the 12 steps. Call your sponsor. Do service work. Read the

book. Work with newcomers. And looming over it all is the belief

that God will relieve you of the desire to drink - if you do these

things. So one day at a time AA's do what they believe will keep them

sober and many do stay sober. (Is this not the idea behind " Fake it

until you make it? " ) I lived for years knowing this, having only a

few problems with it because I believed everyone had their problems

that needed to be faced, that this was mine, and AA was a small price

to pay to avoid the alternative.

>

> I honestly believed for a time that the alternative to

working the AA program was jails, institutions, and/or death; that if

I stopped going to meetings, working the program, or had I not joined

AA in the first place, serious consequences would have followed. Of

course AA literature allows that alcoholics have been known to stay

sober without AA, but I think the Big Book describes these cases as

" comparatively rare. " Except for the fairly common stories of

alcoholics who manage to " white knuckle " their way through life in

their hellish existence without AA I've never seen a group show the

slightest hope of this happening, so I think it's safe to say that AA

believes this in theory only. In practice Alcoholics Anonymous

believes an individual is screwed unless they work the program, and

even then the general opinion is that a lot of them will die drunk

anyway. Look at the whole picture. A roomful of people tell you that

they're your best friend, only they can understand your problem, and

that if you are indeed an alcoholic, your only hope is AA, and nobody

gets to AA by mistake, right? They say you should take what you want

and leave the rest but then they also say it's suggested you work the

program like it's suggested you wear a parachute if you jump out of an

airplane. This and more helps create the opposite of a placebo

effect, namely the Nocebo Effect of Alcoholics Anonymous. The action

of not doing what is suggested by AA causes a return to drinking.

>

> One day at a time, 3-5 times a week AA members hear over

and over and over again how they will slip back into the old life if

they don't attend meetings or stop working the program. " Meeting

makers make it, " and " If you don't go to meetings, you aren't here to

see what happens to people who don't go to meetings, " are only a few

phrases that create this self-fulfilling prophecy. At the very least

members hear that missing a few meetings causes an alcoholic to become

testy and " squirrel cage, " because they're not getting what they need

to remain mentally balanced, their medicine as it were. This implies,

of course, that further missed meetings will result in the ultimate

mental imbalance for an AA - the next drink. Slogans such as " If you

don't work a fourth you'll drink a fifth, " show further the mindset in

AA that a member who fails to work the program by certain guidelines

is destined to drink.

>

> What gives even more power to the nocebo effect in

Alcoholics Anonymous is the awesome and unnecessary power members

continue to give alcohol. A person who considers their life. One

would think that the first goal of a person looking to attain

abstinence would be to stop giving alcohol all that power. In AA the

opposite happens. New members are offered a conception of alcohol as

" cunning, baffling, and powerful.and patient. " It's not that last

drunk or all the other drinks that makes a person an alcoholic,

according to many. To them, what makes a person an alcoholic is the

fact that somewhere out there is that next drink with their name on

it, over which they have no worldly power, and only through the Big

Book, sponsorship, and the fellowship of Alcoholics Anonymous can a

person stay sober. And even then it can be done only for today!

>

> What has happened is that in order to keep its members from the

bottle, Alcoholic Anonymous has created for themselves a certain

alcoholism-induced reality that lives not only in the meeting rooms,

but has found its way into treatment centers, courtrooms, and most

other places problem drinkers might find themselves or turn for help.

You don't even have to go to an AA meeting to be told that you can't

stay sober without AA. (Because if you could stay sober without AA you

wouldn't have to ask for help, right?)

>

> Even if they don't like the program or attend AA

meetings, people buy into its definition of their problem and it hurts

them. AA's Boogeyman worldview of alcoholism where that darn alcohol

is gonna get you if you don't work with a Higher Power and do what AA

says doesn't appeal to everyone. Unfortunately, many do keep the idea

of the Boogeyman, and when they can't or won't join AA for any number

of very good reasons or choose to leave the program behind them, the

Nocebo Effect of Alcoholics Anonymous is one very large factor of

those who become AA's evidence of the need to attend meetings. As

always, those who do fine without AA are not talked about.

[Guest guest]

> > Nate, are you the author of this?

It's been my weekend project. I'd actually never heard of the term Nocebo until a week ago. I learned online that it's a pretty new word - it's not in my 4-inch thick 1998 dictionary. I came across it in a book I'm reading in a section talking about the study of voodoo. It seems that voodoo hexes can kill people but the person has to believe it will kill them, must have seen hexes kill other people, and the world the hexee lives in must believe that a voodoo hex can kill a person.

Will you be posting it on your site, coz if not, I'd love to post it.

I'm putting it the updated version of www.sobrietyfrontiers.com but I'd be honored if you posted it on www.aadeprogramming.com. I found one sentence that was messed up during a cut/paste maneuver that I've since fixed. I'll send you the final version if you like.

Nate

> >

[Guest guest]

Nate s wrote:

>After a short time in AA I began to see an obvious placebo

>affect at work in the program.

[snipped for brevity]

Hello, I'm a former AA member who just joined the " 12-step-free "

list. I resumed drinking about three years ago after nearly

six continuous years of sobriety and constant attendance at

AA meetings (and that doesn't include the hundreds, if not

thousands of hours spent going to AA meetings *before* I

finally quit) not to mention the many meetings I've been

attending off and on over the past three years or so trying

to recapture my long-lost sobriety.

Just wanted to thank you for the VERY enlightening comments

I've been reading on this list. I also found the " AA deprogramming "

et. al. websites extremely enlightening as well. I do want to

stop drinking permanently (coincidentally, my last drunk was

nine days ago on Christmas Eve day ), but I do NOT want to return

to AA.

Don't get me wrong, it's not that I " hate " or " despise " AA,

but I simply don't want to go back to AA for precisely the same

reasons many of you don't.

In fact, that's how I discovered this list just last night. I

was sitting here, thinking that if I want to stay sober, then

I better by gawd get to an AA meeting, start all over again,

exhibit the appropriate display of " humility " and " honesty " by

picking up yet another " surrender " chip, dutifully and humbly

nod up and down as they tell me to " keep comin' back...don't

drink, don't think and go to meetings...fake it'till ya' make

it...it gets better...a day a time...yada yada yada. " I so

dreaded the idea that I thought " there has got to be a better

way " and searched the net looking for something else. And

that's how I found this very enlightening list.

I must admit, however, that given my recent track record, deep

down I'm skeptical about my odds of staying sober without AA

(probably due to years of AA brainwashing?) but I seriously do

wish to quit drinking permanently and be happy.

Thanks,

Mike Marron

[Guest guest]

check out the links to alternative programs in this groups links

page.

SMART, RR and MM.

i think MM is only one which deals with moderation , maybe

smart does as well, but i think it mainly absitence oriented.

>

> >After a short time in AA I began to see an obvious placebo

> >affect at work in the program.

>

> [snipped for brevity]

>

> Hello, I'm a former AA member who just joined the

" 12-step-free "

> list. I resumed drinking about three years ago after nearly

> six continuous years of sobriety and constant attendance at

> AA meetings (and that doesn't include the hundreds, if not

> thousands of hours spent going to AA meetings *before* I

> finally quit) not to mention the many meetings I've been

> attending off and on over the past three years or so trying

> to recapture my long-lost sobriety.

>

> Just wanted to thank you for the VERY enlightening comments

> I've been reading on this list. I also found the " AA

deprogramming "

> et. al. websites extremely enlightening as well. I do want to

> stop drinking permanently (coincidentally, my last drunk was

> nine days ago on Christmas Eve day ), but I do NOT want to

return

> to AA.

>

> Don't get me wrong, it's not that I " hate " or " despise " AA,

> but I simply don't want to go back to AA for precisely the same

> reasons many of you don't.

>

> In fact, that's how I discovered this list just last night. I

> was sitting here, thinking that if I want to stay sober, then

> I better by gawd get to an AA meeting, start all over again,

> exhibit the appropriate display of " humility " and " honesty " by

> picking up yet another " surrender " chip, dutifully and humbly

> nod up and down as they tell me to " keep comin' back...don't

> drink, don't think and go to meetings...fake it'till ya' make

> it...it gets better...a day a time...yada yada yada. " I so

> dreaded the idea that I thought " there has got to be a better

> way " and searched the net looking for something else. And

> that's how I found this very enlightening list.

>

> I must admit, however, that given my recent track record, deep

> down I'm skeptical about my odds of staying sober without AA

> (probably due to years of AA brainwashing?) but I seriously do

> wish to quit drinking permanently and be happy.

>

> Thanks,

> Mike Marron