Book: Review/Commentary: Resisting 12-Step Coercion: How to Fight Forced Participation in AA, NA, or 12-Step Treatment

Abstract

Resisting 12-Step Coercion: How to Fight Forced Participation in AA, NA, or 12-Step Treatment, by Stanton Peele and Charles Bufe with Archie Brodsky (Tucson, AZ: Sharp Press, 2000), 204 pp., $14.95 paper. Background Between 1930 and 1970 a multifactioned modern alcoholism movement sought and achieved a significant change in America's perception of alcoholism and the alcoholic (Johnson, 1973; Roizen, 1991). At the apex of this destigmatization campaign (perhaps the moment First Lady Betty Ford spoke to the nation about her addiction and recovery), the movement was eclipsed and subsequently colonized by a larger addiction-treatment movement. The burgeoning treatment industry shifted the focus of addiction recovery from indigenous support structures to more formal relationships that were institutional, professional and commercial. Once intertwined, these movements become something of a pop phenomenon in the 1980s, generating a legion of new recovery groups for every imaginable problem and a virtual explosion in addiction-treatment programs. For a brief moment it looked like everyone was addicted to something and that anyone of prominence was going to rehab. It seemed like the whole culture had become enamored of recovery (White, 1998). The excesses of this treatment/recovery movement generated an ideological backlash against Alcoholics Anonymous (AA) and its perceived influence on the philosophical underpinnings of modern addiction treatment, as well as a financial backlash against the treatment industry. The diverse individuals and organizations that led this reaction slowly coalesced into a countermovement. Mirroring the movement it opposed, this anti-12-step movement generated its own organizations, its own stable of celebrity authors and public speakers, and its own cultural trappings (web sites, books, t-shirts, bumper stickers). The authors of Resisting 12-Step Coercion are among the vanguard of this countermovement, and their latest book reflects much of its evolving character. Resisting 12-Step Coercion is valuable in that it calls attention to the fact that addiction treatment in the United States is becoming increasingly coercive and intrusive. We agree that the growing emphasis on coercion raises serious ethical and legal questions and undermines the fundamental character of treatment and recovery. Despite our agreement with the authors on this basic point, however, we believe that they (1) misidentify the source of coercion as Alcoholics Anonymous; (2) fail in their promise to offer solutions to those being coerced into mutual aid or treatment; and (3) present their work with a stridency that serves only to quicken polarization among those concerned with alcohol and other drug problems. In our view, Resisting 12-Step Coercion misses the opportunity to explain the limitations of coercion and the forces that have contributed to our growing confidence in the use of threats. Premises and assumptions Resisting 12-Step Coercion is a series of topical essays that collectively provide an overview of the nature of the alcohol problem, of the dominance and (according to the authors) ineffectiveness of 12-step groups and 12-step treatment as a response to that problem, and of the ethical and legal issues involved in coerced participation in 12-step groups and 12-- step treatment. The book is based on the following nine propositions: 1. The AA philosophy is based on a demonstrably false premise: that alcoholism is a disease that completely overtakes the alcoholic's power of choice and requires complete surrender to outside help. 2. The AA program resembles a cult because its members are indoctrinated with what is essentially a rigid, intrusive religious doctrine. 3. The AA philosophy reflects a one size fits all approach that precludes viable alternatives. 4. AA and AA-oriented treatment are ineffective and potentially harmful. 5. As an institution, AA has actively solicited and encouraged membership recruitment by enlisting the courts, employers and correctional agencies as referral sources. …