Answer to Vaillant Speech

This is a report that was posted to the Internet, describing a speech given by Harvard Professor George Vaillant, who is one of the non-alcoholic Trustees of Alcoholics Anonymous World Services, Inc.

The original text is black, and my comments are blue.

Subject: Dr Stephen Jurd's report from Professor Vaillant's talk in Boston.

Standing Ovation For Harvard Professor.

I have never heard an audience clap as long, loudly and spontaneously as at the Boston Park Plaza Hotel where the Harvard Medical School's Department of Continuing Education had its 23rd Annual Addictions Course on March 3rd and 4th. Professor George Vaillant, he of "The Wisdom of the Ego" and "The Natural History of Alcoholism" presented an enthralling paper entitled "Alcoholics Anonymous: Cult or Magic Bullet".
Just watching politicians do their acts proves that quite a variety of pompous liars can get a crowd of fools clapping for them. That alone is no great accomplishment.

He said that AA is "more like penicillin than the Moonies". He reiterated the theme outlined in The Natural History of Alcoholism by stating that there are four factors associated with sustained recovery from addictions:
(i) Compulsory supervision
This is total bull. Many more people recover on their own, without A.A., than with A.A., by a factor of five. (And that isn't just my opinion; The Harvard Medical School says so.) The recovering addicts do not have any compulsory supervision in their lives, to help them to, or force them to, stay sober. So fascist discipline is not necessary for recovery from alcoholism or drug addictions.

And A.A. is not at all like penicillin. Penicillin actually works. A.A. doesn't. Penicillin works at least 95% of the time, while A.A. with its 12 steps fails at least 95% of the time.

(ii) Substitute dependence
This is some more bull. Transferring an addiction from a chemical to A.A. is not an improvement. It is a horrible development. Becoming truly free of addictions is the desired goal, not a lifetime of emotionally-crippled dependency. And addiction to a cult religion is even worse.

(iii) New love relationships
This is a really sick joke. Few new "love relationships" develop in those meetings. In fact, new members are explicitly told, repeatedly,
"Do not get into any new relationships for the first year!"
Some new friendships may or may not develop. All too often, shallow or exploitative relationships develop.

Read Rebecca Fransway's book, AA Horror Stories, before jumping to any conclusions. She documents far too many tales of exploitation and unloving relationships. And A.A. sponsors who are neurotic manipulative personalities, sexual predators, and rapists.

and (iv) Increased spirituality and religiosity.
Teaching people to yammer "Higher Power" is not necessarily an increase in "spirituality and religiosity." I *really* want to hear how Prof. Vaillant measures this parameter.

What shall we do to measure increased "spirituality and religiosity"? Obviously, we will need something far more sophisticated than just counting how may times per hour people parrot buzz-words like:

  • "spiritual",
  • "powerless",
  • "God",
  • "sanity",
  • "Higher Power",
  • "my God is H.P.",
  • "surrender",
  • "defects of character",
  • "confess",
  • "miracle",
  • "group",
  • "as we understood Him".
So, if we don't just count buzz-words, just what are we going to measure?

Besides which, who proved that getting an increase in so-called "spirituality and religiosity" is necessarily a good thing? Very evil cults do the same thing too... Just ask Jim Jones, David Koresh, and Marshall Herff Applewhite. (The People's Temple cult at Jonestown, the Branch Davidian cult in Waco, Texas, and the Heaven's Gate cult in San Diego.)

Increased superstition is a bad thing. Teaching people to depend on an imaginary Fairy Godmother or other vague, undefined "Higher Power" to solve all of their problems, instead of depending on themselves and realistically working on their problems, is a very bad thing. It encourages people to be delusional and mentally ill, rather than sane and realistic.

He then went on to explain how AA embodies each of these factors.

Firstly, AA provides an external conscience by the regular contact with fellow members encouraging abstinence and personal growth.
Here, we actually agree on something. The moral support of a group can be a good thing. But there is no "external conscience" to replace a "broken" inner conscience. It's just group pressure urging successful abstinence. Note that you can get this same group support from any rational recovery group, like SOS, SMART, WFS, or even just your own circle of dry friends.

Secondly, AA understands bad habits need substitutes and so gives new members rigorous and time consuming programs of action.
Giving someone a substitute addiction is not "personal growth", any more than switching someone from an illegal heroin habit to a legal alcohol habit is personal growth. An A.A. 12-step meeting addiction is itself a bad habit. Wasting people's time with "time-consuming programs of action" that accomplish nothing is not "personal growth." A far better use of people's time would be to tell them the whole truth about everything and teach them techniques for coping with cravings.

Thirdly AA provides new, mutually caring relationships, uncomplicated by alcoholism induced guilt, social or financial debt.
This might or might not happen. You might find a friend, or you might find a neurotic self-centered loser, or a control freak, or a sexual predator. Again, read Rebecca Fransway's book, AA Horror Stories. Or check out my short list of problems. Or check out the Midtown Group for sponsors raping under-age girls.

Fourthly, the 12 steps are spiritual, and recovering alcoholics need atonement.

The 12 steps are no more spiritual than the teachings of any other cult. After all, the 12 steps are just Frank Buchman's cult religion, rehashed. Try Reverend Jim Jones and his "Drink More Cyanide Kool-Aid!" Last Step Program for some really "spiritual" cult teachings that will have you talking to God in no time.

Even if it were a religion, A.A. cannot offer atonement for sins, can it? An individual atones for his sins by doing penance or making amends, or both. That individual can atone just as easily without A.A., or any other church, for that matter.

Vaillant reminded all of the guilt relieving properties of alcohol by saying "Only God can be as forgiving as gin."
Thank you, Prof. Vaillant. Now it is blatantly obvious that you are giving us your religious beliefs, not any medical or scientific facts about alcoholism.

He went on with consummate subtlety to link the spirituality of AA to their often acknowledged use of the group itself as a "Higher Power", which in turn he linked to Jung's notion of humanity linked in common spirituality, which in turn he linked to Marx's idea of religion being the "opiate of the masses", which in turn he linked to the effect of opiates on the brain and the way they effect deeper brain structures, inaccessible to logic, willpower, psychoanalysis or CBT. (He reminded us that "Alligators don't come when they're called.") Thus he contended that AA's spirituality affects those parts of the reptilian brain otherwise inaccessible to treatment.

This is quite a load of bull...
No matter how much he used "consummate subtlety" to link together a bunch of unrelated things, declaring that A.A. cult religiosity ("spirituality") works on the opiate receptors in the reptilian brain is just such total bull that it is hard to believe that he can say it out loud with a straight face, never mind actually believe what he is saying. Is this Professor Vaillant another lunatic, or what? This sounds far too much like the ravings of Bill Wilson and Dr. Harry Tiebout, two other A.A. heroes who found that real facts and rigorous honesty were unnecessary bothers.

Since Prof. Vaillant passes himself off as a scientist, perhaps the good professor would like to show us some genuine scientific research, some real experiments with controls, that show how A.A.'s bombastic religiosity works on the human brain? I'll bet that there is no such research, so Prof. Vaillant is just blowing hot air.

Plus, I'm surprised that a Harvard Professor cannot tell the difference between the opiate receptors in the brain, and the dopamine receptors. The opiate receptors are activated by beta endorphins and opiates like opium, morphine, codein, and heroin, and nothing else. That is the body's pain-killer system. The dopamine receptors are triggered by L-dopamine, the production of which can be triggered by a wider variety of stimuli, some of them very non-drug-oriented, like the feeling of satisfaction that comes from a job well done, or the satisfaction that comes from sex. The dopamine system is the body's pleasure system. Why do I seem to know more about the functioning of the human brain than Professor Vaillant, when I don't even have a degree in the subject? What's his problem? And why is he lecturing so far out of his field of expertise that he doesn't even seem to know what he is talking about?

He told us that AA works.
That comes as no surprise. That has always been Prof. Vaillant's opinion and wish, since even before he ever tried using 12-step therapy on his patients. Really do read his book, The Natural History of Alcoholism, where he clearly described, on pages 283 and 284, how excited he was to start using the new 12-step therapy on patients. His enthusiasm for A.A. and Twelve Step therapy was only slightly dampened by his discovery that it didn't work:

To me, alcoholism became a fascinating disease. It seemed perfectly clear that ... by turning to recovering alcoholics [A.A. members] rather than to Ph.D.'s for lessons in breaking self-detrimental and more or less involuntary habits, and by inexorably moving patients from dependence upon the general hospital into the treatment system of A.A., I was working for the most exciting alcohol program in the world.
      But then came the rub. Fueled by our enthusiasm, I and the director, William Clark, tried to prove our efficacy. ...
      ... After initial discharge, only five patients in the Clinic sample never relapsed to alcoholic drinking, and there is compelling evidence that the results of our treatment were no better than the natural history of the disease. ...
Not only had we failed to alter the natural history of alcoholism, but our death rate of three percent a year was appalling.
The Natural History of Alcoholism: Causes, Patterns, and Paths to Recovery, George E. Vaillant, Harvard University Press, Cambridge, MA, 1983, pages 283-285.
The same text was reprinted in Vaillant's later book, The Natural History of Alcoholism Revisited, George E. Vaillant, Harvard University Press, Cambridge, MA, 1995, pages 349-352.

Still, Vaillant really wishes that A.A. worked, so he goes around saying that it works.
Still, Vaillant is really in love with the Alcoholics Anonymous cult religion, so he still insists that all alcoholics must get sent to it, even if it doesn't help them with their alcoholism, even if it kills them.

Emrich's recent review showed that attendance at AA meetings, having an AA sponsor and doing the 12 steps all correlated with good outcome in several studies. Project MATCH showed some superiority of Twelve Step Facilitation over CBT at 3 year follow up.
Project MATCH was one of the most screwed-up "research" projects that the government ever funded. There were no controls. The subjects were biased, were cherry-picked, and were told what results were expected and desired. Then, when it was over, the researchers deliberately misinterpreted the results to claim that the research showed that treatment works. The only thing that Project MATCH proved is that some fools can waste $25 Million.

And Prof. Vaillant knows that. He cannot not know it. There has been far too much loud public debate on Project MATCH, including the retraction and reinterpretation of the results when critics pointed out the flaws after the first public release of the results. So Prof. Vaillant is blatantly deceiving the crowd at this point. He must know what the real truth is, and he isn't telling it.

And Bill Miller, once an important protagonist of controlled drinking, found at 8 year follow up that most of his good outcome patients, selected as aspirant controlled drinkers, had achieved abstinence through AA. The founder of "Moderation Management" is now an AA member!
Thank you, Thank you, Thank you, Vaillant. Few A.A. boosters will admit that Audrey Kishline, the founder of "Moderation Management", went back to being an A.A. member. They won't admit it, because after three months of A.A. "help" and "therapy", she relapsed, went on a huge binge, drove drunk, and killed two people in a crash. Now she is going to prison for manslaughter. She was a hell of a lot better off before she got the help of A.A. and the Twelve Steps.

But what the heck, Keep Coming Back, It Works!

Lastly he told us why AA is not a cult:
(i) The strict outlines of recovery AA style are solely to produce liberty and longevity. All components of AA are voluntary.

  1. Ever heard of court-ordered attendance?
  2. Ever heard of "Go to the meetings, or you will be violating your probation."
  3. Ever heard, "Work the Steps, or Die!"
  4. Ever heard of "This treatment facility uses 12-step therapy. Go to 3 meetings per week, or even better, one per day, or get kicked out of the program."

The "strict outlines" produce a substitute addiction, not recovery. Didn't Prof. Vaillant just brag about the new substitute dependency up above? A new dependency, a new addiction, is not liberty.

(ii) No AA member has power over another one.

  • Ever heard of a sponsor? Ever heard, "Do what your sponsor says, or you will relapse and die drunk."?
  • Ever heard, "Do what your sponsor says, or he will tell your parole officer"?
  • Ever heard of "You must surrender your will and your life to your Higher Power, and your Higher Power can be the A.A. group"? The Big Book contains explicit instructions to surrender to the group:

    Since I gave my will over to A.A., whatever A.A. has wanted of me I've tried to do to the best of my ability.
    The Big Book, 3rd Edition, page 340.

(iii) AA members are not separated from the rest of the community — you can be shunned in one AA meeting and comfortable in another — the old AA saying is that "All it takes for a new meeting is a resentment and a coffee pot."
This is a bogus distinction. When you are in a meeting, you are in A.A., not in "the rest of the community." When your sponsor is having you do the Twelve Steps, you are in A.A., not in "the rest of the community." A cult does not have to buy a farm and set up a compound with armed guards and barbed wire to be separated from the rest of the community. Only the most extreme cults practice total physical isolation of cult members from the rest of the community.

(iv) AA recruits by attraction not promotion.
Baloney. T.V. advertising, compulsory A.A. attendance for "therapy program" patients, "90 Meetings or 90 days in jail" for drunk drivers, and "Get a sponsor" for parolees are not "a program of attraction," they are promotion and even coercion. See the cult test for a description of the numerous aggressive recruiting and self-promotion strategies of Alcoholics Anonymous.

(v) The Twelve Traditions are an important preventive measure to cult like behaviour.
More bull. They are part of the problem. Tradition One says that no one can break A.A. unity, so conformity and uniform group-think and cult-speak are the order of the day.
And Tradition Eleven says that A.A. is supposed to be a program of attraction, not promotion, but we just dealt with that issue.

(vi) AA has a sense of humour. They keep in mind Rule 62: "Don't take yourself too seriously."
Again, more total bull. They have no humor whatsoever. They pretend to have lots of humor, by laughing and joking about everything and anything except those things that are really important, like Bill Wilson's insane ravings, the crazy A.A. dogma, or the nasty cult characteristics of Alcoholics Anonymous. A.A. encourages members to tell jokes about themselves and their friends, to reinforce the idea that A.A. members are all foolish and stupid and need the supervision of a sponsor, but A.A. forbids criticism or ridicule of A.A. itself.

Those true believers who think that they have a sense of humor should go read my recovery jokes and then report back how funny they find the jokes and how much they laughed... I really want to hear about the results. (What I do hear is that they go ballistic and have a hissy-fit.)

Those six characteristics of a cult that Vaillant just listed are hardly a complete list of cult characteristics. They aren't even "sort of" a good list. I have 100 items on my list of standard cult characteristics, and A.A. scores an 'A' as a cult when rated on them. Check them out.

It was a wonderful experience just to be in an audience so warmly appreciative of such a major intellect and contributor to our field.

comments by Dr Stephen Jurd, Psychiatrist, Head of Drug and Alcohol
Department, Royal North Shore Hospital, Sydney.

Glad you enjoyed the show. Have a good life anyway.

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Last updated 4 August 2012.
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