The Sober Truth (28 page)

Journal of Nervous and Mental Diseases
,

24

Journal of Substance Abuse Treatment
,

147, 149

Jung, Carl, 18

Kaiser Permanente Chemical Dependency

Recovery Program, 61

Kaskutas, L. A., 50, 123

Keeley, Leslie, 12–13

Keeley Institutes, 12–13

Kennedy, Foster, 24

Ladies’ Home Journal
, 24

Lasker Award, 26

legal issues: court-mandated 12-step

attendance, 26–27, 111, 125–126; drug

courts, 28; Prohibition, 13

Liberty
magazine, 21

longitudinal studies: punctuated nature

of, 43–44, 151; surveys in, 41, 42

Los Angeles Times
, 69, 71

Macbeth
(Shakespeare), 89–90

Majer study, 51

Mann, Marty, 24–25, 26, 27

“March of Time” newsreels, 24

Markey, Morris, 21–22

McClellan, A. Thomas, 71

McCrady study, 39

McKellar studies, 45, 47–50, 56, 75–76,

123

medical profession, AA antipathy toward, 22–23

Menninger Clinic, 59

“Mighty Destroyer Destroyed” (essay),

11

“Minnesota Model” of treatment, 60

Moore’s Brook Sanitarium, 78

Moos study, 40–44; compliance effect

in, 41–42; on dropouts, 52; group

dynamics, 123; lack of data on treatment,

40–41; objectionable methods

of, 43–44

moralistic views of AA: addiction as

failure of morality, 5–6, 13, 98–99, 110;

character defects of addicts, 141–142,

145; salvation through surrender,

135–136; tally system and, 136–137

motivation, studies of, 50–52

“motivational enhancement therapy,” 41

multiple regression analysis (MRA),

39–40

mutual support, 57

Narcotics Anonymous, 56

National Council on Alcoholism and

Drug Dependence, 25

National Institute on Alcohol Abuse

and Alcoholism (NIAAA), 27, 33, 52,

55, 150

National Institute on Drug Abuse

(NIDA), 85–86, 159

National Institutes of Health (NIH), 30,

150

National Longitudinal Alcohol

Epidemiologic Survey, 52

neurobiology of addiction, 85–88

newcomers to AA: demands made of,

107–108; lack of support for, 105–107

New York Times
, 71–72

New York Times Magazine
, 30–31

90/90 prescription, 140–141

Nixon, Richard M., 27

noise (statistical turbulence), 42, 54, 151

observational studies: compliance effect

in, 32–33, 39, 40, 41–42; controlled

studies compared, 29–32; correlations

in, 30–31, 38–39; selection effect in,

31–32, 46

obsessive-compulsive disorder (OCD),

83, 90, 115

“Ocean Therapy,” 64–65

“one day at a time” myth, 139

“one-size-fits-all” treatment, 137–138

Oursler, Fulton, 21

Owen study, 125

Oxford Group, 2, 4; moralistic approach

of, 135, 142; Wilson as member of,

17–18, 19

Passages Malibu, 64–65, 69, 71

peer group influence, 139–140

percentage of days abstinent (PDA),

74–75

personal relationships: in AA, 105, 119,

123; ruined by alcoholism, 116;

“13th-stepping,” 108, 117–118, 130

physical addiction, 81, 82–85

Pinsky, Drew (“Dr. Drew”), 56, 57, 76

placebo effect, 33

platform agnostic networks, 156

powerful figures, identification with,

127–128, 129

powerlessness.
See
helplessness

prediction of addictive urges, 139

prefrontal lobotomy, 13

probability, 154

Project MATCH, 55–56, 150

Promises Malibu, 61, 69, 76; claims of,

77; costs of treatment, 71; duration

of residence, 62; “enhancements”

to treatment, 59–60; extra features

of program, 64

Promises Treatment Centers, 123

proselytizing, 3

psychiatric centers, 68–69

psychodynamic therapy, 158, 159

psychological addiction, 81, 82–85

psychological depression, 83

psychological insights, 130–131

psychological precipitants of addiction,

156–157

psychological significance of decision

making, 87–88

psychological testing, 68–69

psychology of addiction, 89–95; case

reports, 90–91, 93; failure to study,

152–153, 155; forms of helplessness, 127;

as map for treatment, 93–95; physical

addiction contrasted, 82–85; reversing

helplessness, 145; self-medication

hypothesis, 82–83

Psychology Today
, 62, 96

psychotherapy: “addiction counselors”

unfit to provide, 143; difficulty of

quantifying results, 157–158; long

follow-ups required in, 159; personal

empowerment due to, 7–9; success in

breaking addiction, 94–95; in understanding

addiction, 156–157

public relations, 21–24, 60, 78

“qigong therapy,” 63–64

rage at helplessness, 92

randomized studies.
See
controlled

studies

rational behavioral therapy (RBT), 34–35

Rational Emotive Therapy (RET), 67–68

rehabilitation centers.
See also specific

treatment centers
: AA and, 58,

60–61; aggressive marketing by,

60; “Cadillac” rehabs, 9–10, 59–60;

coercion in, 97–98; in competitive

market, 78–79; consequences of

failure in, 76–77; costs of (See cost of

rehab programs); exorbitant costs

of (See cost of rehab programs);

extra features of, 59, 63–70; history

of, 58–60; ideal design of, 79–80;

lack of individual therapy in, 65–68;

negative experiences with, 112–115;

non 12-step based, 61; outcome data

of, 72–76; repeated failures of, 9–10;

role of hospitalization, 62–63; stress-

relieving settings of, 122; 12-step

based, 58–80, 103–104

Reiki treatments, 64

relapses, 137

religion: in AA steps, 104, 112, 125,

128–129; close bond with AA, 4–5, 17,

27; court rulings on AA and, 125–126;

fundamentalist groups, 2, 121; preaching

salvation through surrender to

God, 135–136; 12-step obsession with,

98–99, 104, 106–107, 120

Robins study, 83–84, 86–87

Rockefeller family, 11

Rush, Benjamin, 11–12

Sack, David, 62, 123–124

Sacket, David, 37

St. Jude Retreats, 61

sanitaria, history of, 78–79

Sanitarium at Dansville (NY), 78

Saturday Evening Post
, 11, 22, 24

scientific method, 29, 43–44, 48

seeking behavior, 88

selection effect (bias): compliance effect

of, 32–33; in observational studies,

31–32, 46

self-examination, 121, 142

self-fulfilling prophecy, 45

self-medication concept, 85

self-reporting: anecdotal (See individual

experiences); as questionable

metric, 35, 43; through surveys, 41, 42;

underreporting bad outcomes, 72–74;

unverified, 49–50

self-selection, 51

sexually predatory behavior in AA, 108,

117–118, 130

Shakespeare, William, 89–90

Shoemaker, Sam, 19

Sierra Tucson, 9, 10, 58; claims of, 76–77;

costs of treatment, 71; extra features

of program, 63–64; “Individualized

Treatment Plans,” 68; “Sierra Model”

of treatment, 61

Silkworth, William, 21, 22

Silver, Nate, 153

SLIP (sobriety loses its priority), 137

Smith, Bob, 19–20

smoking, 85

spas, rehabilitation centers as, 59–60

SPECT brain imaging, 64

spirituality.
See
religion

sponsorship: failure of, 129; fear of, 118;

fitness of sponsors, 143; negative experiences

with, 106, 108, 110; unrelated

to abstinence, 126

spontaneous remission: study of, 55–56,

150; treatment efficacy and, 53–55, 56

statistical methodology, 43, 48–49, 151–152

statistical turbulence (noise), 42, 54, 151

structural modeling, 47–48

successful treatment: cost of rehab

programs and, 70–72; defined, 33–34;

involvement with program and, 48,

50, 52–53; loss of efficacy over time,

75; spontaneous remission and, 53–55,

56; through psychotherapy, 93–95

success rates: of AA, actual, 1–2, 122;

of AA, claimed, 23–24, 34; of rehab

centers, claimed, 72–74

suicide, AA and, 102–103, 108–109, 110

surveys: in longitudinal studies, 41, 42;

questionable size of, 43; triviality of,

148–150

susceptibility to addiction, 88–89

“tally system,” 7, 136–137

Taubes, Gary, 30–31

temperance movement, 12

Thacher, Ebby, 18

“13th-stepping,” 108, 117–118, 130

Tiebout, Harry, 26

Timko study, 45, 147

tolerance to drugs, 81

Tonigan study, 125, 126

treatment industry: AA as monopoly

in, 2–4, 131, 155; rehabilitation centers

(
See
rehabilitation centers)

treatment of addiction/alcoholism:

failure of (See failure of treatment);

“one-size-fits-all,” 137–138; psychology

of addiction as map for, 93–95; by

psychotherapy (See psychotherapy);

studies of (See addiction treatment

studies); successful (See successful

treatment); TSF (See twelve-step

facilitation therapy)

Treatment Research Center, 71

twelve-step facilitation therapy (TSF),

1–10.
See also specific programs
;

AA monopoly, 2–4, 131, 155; ability

of addict to respond to, 132–133;

claims of, 34–36; court-mandated

attendance, 26–27, 111, 125–126; critiques

of, 1–2; demeaning treatment

of addicts in, 143–144; designing

study of, 158, 159; devotion to, 95;

impaired physician programs, 28;

obsession with religion, 98–99, 104,

106–107, 120; rehabilitation centers

based on, 58–80, 103–104; relationship

with abstinence, 47; as setup

for failure, 103, 105–106, 114; studies

of, 50–51

Vaillant, George, 54–55

Varieties of Religious Experience

(James), 18

Vederhus study, 45–46

Walsh study, 36, 39

Weiss study, 50–51

Wilson, Lois, 17, 24

Wilson, William Griffith (“Bill”), 11,

120; alcoholism in family of, 14–15;

conversion experience of, 2, 17, 18–19;

emotional struggles of, 15, 16, 17–18;

founding of AA, 19–20; multiple

compulsive behaviors of, 15–16, 93; on

religion in AA, 4, 125; religious faith

of, 16–17; spreading influence of AA

and, 24, 25, 27

Winehouse, Amy, 76

Wired
magazine, 56

Witbrodt study, 46, 47

withdrawal syndrome, 82

Yale University, 11, 25–26

Zimburg study, 54