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, that only they can understand your problem and if you are indeed an alcoholic your only hope is AA. They also tell you nobody gets to AA by mistake. 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 that 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 if they 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 himself or herself a candidate for Alcoholics Anonymous has probably already given alcohol a large amount of influence in his 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 their 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 alcoholism is going to get you if you don't turn it over to a Higher Power and do what AA says doesn't appeal to everyone. Unfortunately, many do keep the idea of the Boogeyman. When they decide not to join AA for any number of very good reasons, or choose to leave it behind them, the Nocebo Effect of Alcoholics Anonymous is one of the factors in the failure of those who become AA's evidence of the need to attend meetings.

Nate
http://www.sobrietyfrontiers.com