The truth is indeed sobering, part VII

By Michael G. Brock, MA, LMSW This article is a response to an interview with Dr. Dodes, professor emeritus at Harvard school of psychiatry, by John Lavitt. The book and the interview essentially dismisses 12 step groups, the current substance abuse treatment industry, and the science that supports them, without proposing any concrete alternatives. Moreover, Dodes quotes his own science rather selectively, and sometimes inaccurately. Prior sections are available online. Not a Moral Issue? Lavitt asks Dodes about his problems with the terms searching and fearless moral inventory, which Dodes says is "self-flagellation" and "degradation." Lavitt says the intention as explained to him is to identify resentments and understand the patterns of behavior caused by those resentments. Dodes tells Lavitt he has it wrong, and that, "The theory is clearly moralistic because Wilson invented it. The word moral is not there by accidentâ?¦Wilson makes it very clear by listing all the sins of alcoholicsâ?¦AA could improve itself if it took out all of the moral qualities of it." There is some truth to what both men say is their conception of the purpose of the AA inventory. It is as Levitt suggests, a way to understand dysfunctional attitudes and behavior, and in that way is similar to psychotherapy, but it is also based on the Christian religion. The scriptural basis for confession comes from James 5:16: "Therefore confess your sins to each other and pray for each other so that you may be healedâ?¦" It is also the case that in discussing the inventory in the 12 Steps and 12 Traditions of AA, Wilson suggests using the seven deadly sins as a basis for cleaning house.[i] The connection with recovery is the belief that confessing sins and making amends for harm done to others alleviates guilt, brings peace, and makes it easier for alcoholics to live with their past mistakes. However, it is not necessarily the case that one has to view as sinful what others view as sinful. The important question is, "How do you feel about your own behavior? Do you think it's wrong?" If you repeat a behavior that you think is wrong, you will have trouble accepting yourself, and, therefore, have difficulty staying sober. Conversely, "[E]very act of self-control produces a sense of self-respect."[ii] Atonement for sins is something that Christians brought over from Judaism, Yom Kippur, the Day of Atonement, being the holiest day of the Jewish calendar. However, confessing to another person is a Christian invention. Catholics confess to a priest, and while some Protestants have done away with this practice, others engage in public confession to the entire congregation. In the AA practice, the suggestion is to confess to a spiritual advisor; someone who can offer insight and guidance on an issue. There is a saying that confession is "good for the soul," and I've always believed that something a person couldn't share with anyone else was something he couldn't accept about himself. One of the purposes for which people seek therapy is the act of confession. They want forgiveness and understanding. They want help accepting themselves. Every therapist is in part a priest, and every religious leader is, at best, part therapist. However, relieving guilt is not the whole purpose of the inventory. Another important function is correcting dysfunctional behavior, and key to this process is the insight that dysfunctional behaviors are motivated in large part by fear, "The chief activator of our defects has been self-centered fear-primarily, fear that we would lose something we already possessed or would fail to get something we demanded. Living on a basis of unsatisfied demands, we were in a state of continual disturbance and frustration."[iii] Indeed, it is hard to imagine being greedy without the fear that you will not have enough money, angry without fear that someone has the power to harm you, or lustful without the fear that your sexual needs will not be met, and so on. And this is where AA blends religion and therapy. The underlying assumption of the inventory is that those with faith in a loving God can expect to have their needs met if they focus on doing the next right thing. That is to say, if they focus on what is within their power to control, they do not need to control external environment. Simple as this sounds, it is a rare person who thinks he will always have enough of everything. But it could be that these fears are exaggerated in the addicted population.[iv] This seems to be the premise of the spiritual solution to addiction, and whether one believes in God or not, it is sound psychology to say that if one is at peace with himself and his environment, he is more likely to exhibit healthy, socially acceptable behavior. Lavitt asks Dodes about the attitude he expresses toward the amends steps, that "making amends in the 12-Steps [is] cleansing oneself by apologizing, thus leading to more shame and degradation for the alcoholic or addict." He says, "As I understand it the amends process is not focused on apologizing, but about changing behaviors by asking a person wronged what can be done to heal a wound caused by a past actionâ?¦Why is that process positioned as such a negative in The Sober Truth?" Dodes said that he likes Lavitt's take on it, but objects to the phrase, "When we are wrong, we promptly admitted it." The editor points out that he is talking about the 10th step, not the amends steps, but that is really a moot point. The spirit of the steps is undoubtedly to set right the wrongs of the past and to correct future mistakes as they happen. Dodes says, "If I were writing the 12-Steps, I would never say it that way because it's not a question of right and wrong, it's not a moral issue." Really? Alcoholism and the behaviors of the practicing alcoholic are not moral issues? Here I think that Dodes is at odds with the whole world. Not only does the State of Michigan (the People, as represented by their legislature) think that drinking and driving is a moral issue; it is a breach of the codified morality we call law. The people of every State consider it such, and I have to believe that if it touched Dodes in a personal way he would consider it to be as well. A few years ago, the Federal Government told Michigan that if we did not lower the legal DUI limit to .08 they were going to cut off highway funds. Ask the people from Mothers Against Drunk Driving if they don't consider those who killed their loved ones guilty of immoral behavior. And this is just the most obvious example. How about the guy who steals money from his kid's piggy bank to drink? Or the mother who sells her food stamps for cash to buy drugs and lets her kids go to school hungry? How about the infidelities that break up marriages, or the family members who are hurt and embarrassed by the alcoholic who shows up drunk at the wedding? The people whose neighborhoods are unsafe and where everyone has bars on the windows to keep drug addicts out? To say that there isn't a moral dimension to addiction that has to be set right for the addict to live with himself sober is silly. Moreover, to treat the alcoholic without addressing the guilt he has over his drinking behavior is to ignore the proverbial "elephant in the living room." For an insight oriented therapist, Dodes is showing an incredible lack of insight. Dodes says, "It's an important part of any psychotherapy to recognize the way that you have messed things up and caused troubles in your life and you correct them. You learn about yourself so you can make your life go better in the future." Isn't the essence of morality to decide between right and wrong? Isn't that part of understanding how you "messed things up and caused troubles in your life?" No one can go through a day without making moral judgments, and those who truly don't believe there is a distinction between moral and immoral behavior are people we all fear. -------- [i] The 12 Steps and 12 traditions of AA, P. 48, 48, 66, 67 [ii] Abraham Low, Mental Health Through Will Training, P. 166 [iii] The 12 Steps and 12 Traditions of AA, P. 76 [iv] On page 60-62 of the "Big Book" Alcoholics Anonymous, Wilson gives a description of a life lived according to the principle of "self-propulsion," and how this creates a situation in which people are in a more or less constant state of conflict with others. The result of this tension for alcoholics is out of control drinking, and the solution he proposes is God. -------- Michael G. Brock, MA, LLP, LMSW, is a forensic mental health professional in private practice at Counseling and Evaluation Services in Wyandotte, Michigan. He has worked in the mental health field since 1974, and has been in full-time private practice since 1985. The majority of his practice in recent years relates to driver license restoration and substance abuse evaluation. He may be contacted at Michael G. Brock, Counseling and Evaluation Services, 2514 Biddle, Wyandotte, 48192; 313-802-0863, fax/phone 734-692-1082; e-mail, michaelgbrock@ comcast.net; website, michaelgbrock.com. Published: Wed, Feb 17, 2016