I just found an old article by a seasoned treatment provider/12-step supporter, Dr Abraham Twerski. He’s a psychiatrist who founded the Gateway Rehabilitation Center in 1972, writes extensively, and tours the world speaking about recovery. He also offers a wonderful example of the double-talk, nonsense, and brazen self-contradictory messages of the recovery culture. Check out the article for yourself, and see how many contradictions you can find. I’ll cite a few.
First of all, he is a true believer that addiction is a bonafide disease. However, he’s against the development of pharmaceutical treatments for it:
A pill to cure alcoholism! Just what we’ve been hoping for, right?
Ironically, I see such a development as a disaster.
Why does he see it as a disaster? Because people who quit drinking and drugging without 12-step programs are “dry drunks.”
Even though they are not drinking or drugging, their character and personality has not changed, and their behavior is just as pathological as that of an active addict.
This is where the massive bait-and-switch comes in with 12-step programs. If drinking and drugging is causing problems in your life, then the goal of help should be to eliminate that behavior. But it’s not.
What is the goal then? Well first, we need to sort out Twerski’s view of what alcoholism/addiction is:
We disagree with those psychologists who say that alcoholism is a symptom of an underlying psychological problem, and when that problem is resolved, the person will have no need to drink alcoholically, but may become a safe, social drinker. In most cases, therapy can go on indefinitely without results, because while the patient is waiting for the underlying problem to be resolved, he continues to drink, and nothing is ever accomplished with a dysfunctional brain. We dispute the premise that alcoholism or drug addiction is a symptom, and we say it is a primary disease.
Okay. He thinks that there’s a “dysfunctional brain” involved. He also refutes the idea that it’s caused by other psychological problems. Which would mean that if you solve your other psychological problems, addiction won’t go away, or even be affected. And then he delivers the famous statement that “it is a primary disease.”
What is a “primary disease?” I found a succinct description on another site:
“Alcoholism is a primary…” – what does this mean? According to www.Dictionary.com, a primary disease is, “A disease arising spontaneously and not associated with or caused by a previous disease or injury.” In other words, alcoholism and addiction are not CAUSED by other things. People are not alcoholic (or addicted) because they had a difficult childhood, are in a bad marriage or have a stressful job. If someone is addicted, they would be addicted regardless of external factors.
Got it? Other stuff doesn’t cause addiction – it just happens spontaneously. There’s a problem with Twerski’s views though, because right after he says this:
We dispute the premise that alcoholism or drug addiction is a symptom, and we say it is a primary disease.
He follows it up with this:
Yes, I believe that alcoholism is in fact a symptom. It is a symptom of the absence of spirituality, and the treatment is the development of spirituality.
I don’t know how to make sense of this, because he literally contradicted himself from one sentence to the next. So far, he’s said that addicts have a “dysfunctional brain”; that addiction is not a symptom of other psychological problems; that it is a primary disease, i.e. that it arises spontaneously; and now he says “it is a symptom of the absence of spirituality.” How are we to make sense of all of this?
The website for his treatment center is just confusing. On their front page they state:
Addiction is a chronic disease, not a lack of self-control.
I’m sorry, but WTF is it? Nearly every definition/description of “the disease of addiction” lists “loss-of-control” as its main feature. Is there some difference between someone not being able to control their usage of drugs and alcohol, and some lacking “self-control” that I’m not understanding? Is it any less confusing when on the page describing their inpatient treatment services they state:
Gateway Rehab offers inpatient care, a 28-day program for both males and females. This intensive program focuses on early recovery skills, including an understanding of disease and developing tools to maintain self-control.
Huh? I thought it wasn’t a problem of self control…
And again, what exactly is this disease? It’s a real disease that comes from a dysfunctional brain, but he rejects medication. It’s not a symptom of other psychological issues, “because it’s primary.” But even though it’s primary and NOT a symptom, it’s a “symptom of the absence of spirituality.
This man started a rehab that “serves nearly 1,700 adults and youth daily through four divisions at 20+ locations throughout Western Pennsylvania and Ohio” and he makes no sense whatsoever. He’s confused, they’re confused – and at least 1,700 people a day must also be confused. This is a travesty.
It gets worse. He describes the difference between humans and animals, and points out some important things, such as:
What makes us distinct and unique are a number of features and traits that humans have which animals do not have. In addition to greater intelligence, some of the more obvious ones are (1) the ability to learn from the history of past generations, (2) the ability to search for truth, (3) the ability to reflect on the purpose and goals of life, (4) the ability to have a self-awareness, (5) the ability to volitionally improve oneself, (6) the ability to have perspective, to contemplate the future and to think about future consequences of one’s actions, (7) the ability to be considerate of others and to be sensitive to their needs, (8) the ability to sacrifice one’s comfort and possessions for the welfare of others, (9) the ability to empathize; (10) the ability to make moral and ethical choices in defiance of strong bodily drives and urges, (11) the ability to forgive, (12) the ability to aspire, and (13) the ability to delay gratification.
Again, I don’t know how to make sense of where he’s going with this. I agree that these are all human abilities, but a few directly clash with what he seems to believe is the nature of addiction. He thinks it’s a primary disease with a dysfunctional brain, or at least he say that. Then he says it’s a symptom of the absence of spirituality. And then he says that all of the above abilities, when practiced, are the practice of spirituality. So, choosing to “volitionally improve oneself”, and coupling it with ‘perspective and contemplating the future’ is being spiritual. And that’s what you need to do.
So…. you need to make a different choice? Then what exactly is the “primary disease?” And how do you make a different choice with your “dysfunctional brain?”
And, getting back to a question I asked up top – what then is the goal of “treatment” or “recovery?” Well, the rest of the article lays it out. Oddly enough, the goal is not to stop the problematic behavior. The goal is to live by the commands of 12-step programs; to be spiritual. Here’s a choice quote:
At my very first meeting, it became clear to me that this program was far more than just not drinking. All the 12 steps were things that were unique to humans. No animal can become aware that it has no control over its life. No animal can surrender its will and turn its life over to the will of a Higher Power. No animal can do a moral inventory, admit its mistakes to someone else, seek to correct its character defects, and make amends to those it has harmed. And no animal can go out of its way to help others. Because these steps are all uniquely human, they comprise the spirit, and if one lives according to these steps, one becomes spiritual.
Why does he love AA so much?
You might say, “But, you are a rabbi. Certainly you learned about proper human behavior in your religious studies. Why did you need the 12-step program to help you with your spirituality?”
I’ll tell you why. When we study principles of spirituality in religion, we recognize their importance. However, we do not have a gut feeling that if we deviate from these principles, we die. Even if improper acts are sinful, they are not lethal. But in the 12-step programs, a person who is sincere in recovery knows at a gut level that if he deviates from these steps he is dead. Dead, D-E-A-D. Bill Wilson said it simply: “Without spirituality, we die.” The 12-step program is our oxygen. That’s the feeling about spirituality that I got from the program.
He loves it because it pushes the brand of living he subscribes to, and it makes people feel like they are in mortal danger if they don’t adhere to the 12-steps. I don’t necessarily oppose such a way of life, but let’s be clear about the intention of 12-step programs. They talk nonsense about fake disease and alcoholism in order to scare people into living their vision of a holy life. Would you expect anything less from an organization that got it’s start in a christian cult (the Oxford Group and AA)? Probably not. But I think most people would expect better from psychiatrists and rehabs claiming to treat a bonafide disease based in brain dysfunction.
Again, the man who claims this is a disease with a dysfunctional brain – and is NOT the result of other psychological problems – also worries about the advent of a drug that works through the brain to cure the disease:
I can envision what may happen if they develop a drug to treat alcoholism. People will feel that they have no need for AA, because they’re not drinking. But they will still have the self-centeredness, lack of consideration, dishonesty, manipulativeness, finding fault with others, and all the behavioral traits typical in the active alcoholic and addict.
