Charles Duhigg’s book has made the role of habit in our lives a topic of much discussion lately, and that’s perhaps its greatest value. In trying to fit AA into his “habit loop” formula, however, Duhigg helps to reinforce two popular but seriously mistaken views of a program that, as he recognizes, has rescued millions from the ravages of alcoholism and helped millions more through the influence of its 12 Steps.
According to one of these views, AA amounts to little more than group therapy; according to the other, AA is only concerned with drinking. We alcoholics go to meetings for mutual support so we can quit and not pick up again. End of story. To this Duhigg adds his habit loop twist. AA works because it helps us to exchange one habit for another: going to meetings instead of going to the bar. This, he claims, is AA’s way of applying the “Golden Rule” of habit change: use the same cue (feeling lousy) and deliver the same reward (feeling better), but insert a new routine (meeting instead of bar).
This has all the appeal of simplicity and all the pitfalls of oversimplification. Presented as part of the truth, Duhigg’s description is quite acceptable. Except that he presents it as the whole truth, and what AA says about itself (in its basic texts) and countless alcoholics believe and try to practice, is of little consequence. He either dismisses or diminishes it as being, well, unscientific, a charge Duhigg uses as a trump card against an AA which he says remains “frozen in time,” left behind by the advance of science.
Duhigg sets up a conflict between science and AA which enables him to reduce the latter to group therapy. This follows from his understanding of science as a materialist enterprise. Duhigg recounts how when researchers asked recovering alcoholics what made their new habits take hold so that they were able to stay sober even under the direst of circumstances, their answer was always the same: God. They hated that answer, says Duhigg, because “God and spirituality are not testable hypotheses.”
Yet that is AA’s answer, repeated throughout its “Big Book” and “12&12” and echoed in tens of thousands of rooms throughout the world each and every day. It reflects the view that humans are material and spiritual beings. Reject the latter and you end up treating men and women in controlled experiments the way you treat mice. But being subjects and not only objects, we humans have our own idea of what’s going on inside of us. Thus either you accept alcoholics’ own account of their experience and honestly try to learn from it, or you reinterpret it to fit your materialist bias.
The Power of Habit does the latter. It’s therefore not surprising that the researchers eventually “figured out” that “It wasn’t God that mattered.” Instead, “it was belief itself that made the difference.” As their materialist preconceptions required, the researchers tweaked Step 2 to take the spiritual out so that it ends up making me my higher power once I work up enough self-esteem to believe in myself. This is philosophy masquerading as science, and it dovetails back into pop psychology and the therapeutic commonplace that we drank because we didn’t feel good about ourselves. Those who know the 12&12 will recall a memorable passage that lays that notion to rest.
Seeing spirituality and God not only as unscientific but even as “odd” and “strange,” Duhigg tries to exclude them from the AA story. Where AA sees alcoholism as “a threefold disease”—physical, mental, and spiritual—TPOH admits only to the first two. Where AA considers itself a “spiritual fellowship,” TPOH sees only the communal. Where AA talks of “spiritual principles,” TPOH talks of methods and techniques.
We are left with a spiritually deprived and almost dehumanized portrait of AA as “a giant machine for changing habit loops” which “forces you to create new routines” through “a system of meetings and companionship that strives to offer as much escape, distraction, and catharsis as a Friday night bender.”
Such characterization distorts and trivializes what we alcoholics do. We go to meetings to share “our experience, strength, and hope” and to tell others “what we were like, what happened, and what we are like now,” and thus to “carry the message” that “there is a solution,” which is understood to be spiritual. We go because we want to give back “that which has been so freely given us.” We don’t all understand spirituality and God the same way, but neither do we try to deny or belittle them. As for the language of coercion, none of us would associate it with AA. It is totally foreign to its spirit.
Duhigg’s scientism (to borrow a term from C. S. Lewis) also helps to explain why his book tends to perpetuate the notion that AA is all about drinking. It’s a view that’s been around from the start, and when people act on it in the rooms, we give it a name: two-stepping. They stop drinking and they tell others they stopped drinking. We sometimes call such people “dry drunks.” They never move far beyond physical sobriety.
But AA is no drying machine, as by extension Duhigg’s arid metaphor would have it. Not drinking is only the first step in a process leading to a “spiritual awakening” which enables the alcoholic to carry “this” message and “to practice these principles in all our affairs” so that we can “grow along spiritual lines,” gain emotional sobriety, and live in harmony with God and neighbor. But you wouldn’t know that from TPOH. Duhigg is mum on the Steps that make that process abundantly clear, and when he mentions two of them, he bends them out of shape so they’ll fit into his habit loop scheme.
Thus he cites research to the effect that to do Steps 4 and 5, a person “has to create a list of all the triggers for their alcoholic urges” and that “When you make a self-inventory, you’re figuring out all the things that make you drink.” He adds that “Then, AA asks alcoholics to search for the rewards they get from alcohol. What cravings, the program asks, are driving your habit loop?”
Steps 4 and 5 have the alcoholic to do these things only in Duhigg’s book. His account seems plausible to the uninitiate only because of the way he quotes Step 4: “to make ‘a searching and fearless inventory of ourselves.’” The person in AA will immediately notice a curious omission: the word “moral” is left out. Again, not surprising, since morality is among the “not testable hypotheses.” But it’s a “moral inventory,” because AA is concerned not with the circumstantial habits surrounding our drinking but with the character and emotional habits that cause the harm we do to ourselves and to others. These constitute “the exact nature of our wrongs” which we then admit “to God, to ourselves, and to another human being” in Step 5.
This self-examination and admission of wrongs are among the exterior habits we cultivate in AA as we strive to acquire such interior habits or character traits as honesty, humility, and forgiveness. They proceed from a spiritual awakening that transforms the perceptions and concerns which drove our old habits. We try to practice these new habits daily in all we do and through repeated action the traits are gradually ingrained in mind and brain and develop into habitual dispositions. Right thinking, right feeling, and right action slowly become second nature to us. This is the understanding of habit formation that underlies the 12 Steps of AA and is distilled in the phrase “practice these principles.”
The chain of events that led to AA started when a psychiatrist, Carl Jung, humbly admitted to the limitations of his trade and told one desperate alcoholic that there was no hope for him except in a spiritual experience. Through this man’s agency psychologist William James helped another desperate alcoholic understand the spiritual experience that had just set him free. Bill W. was then led to another man of science named Dr. Bob, and AA was born.
Other psychiatrists, psychologists, and medical doctors would join with men and women of the cloth to support and encourage AA as it borrowed from science and religion and grew into a spiritual fellowship that would launch a different kind of experiment, an experiment in faith. The results are there for everyone to see, in the rooms of AA as well as at home, work, and church. They are every bit as empirical as those little graphs of rat brain activity that adorn TPOH.
We alcoholics are indebted to AA for nurturing such a fruitful tradition of cooperation between science, religion, and the spiritual, a tradition that Charles Duhigg has unfortunately chosen not to follow but which developments in science since the advent of quantum physics are sure to strengthen. It’s not AA that's being left behind, but a hubristic and triumphalist conception of science that remains stuck in the 18th century.
The following preliminary comments were posted 04/25/12 ahead of the above review.
Charles Duhigg’s book is based on the idea that a habit loop made up of cue, routine, and reward accounts for our habits, which in turn account for much of what we do in life. Here’s how it applies to the alcoholic: we feel down (the cue or trigger), we go to the bar (the routine), and we have a few drinks and a few laughs (the reward). What AA does is to make us aware of the cues and rewards and to offer us a different way to respond to them by providing a new routine (going to meetings) to replace the old one.
The excerpts below illustrate these ideas and will be discussed in my review. They are taken from Part One, Chapter One of Duhigg's The Power of Habit: Why We Do What We Do in Life and Business (Random House, Inc., 2012). The numbers in parenthesis refer to the Kindle Edition location.
“Alcoholism, of course, is more than a habit. It’s a physical addiction with psychological and perhaps genetic roots.” (1244-1245)
“What AA provides instead is a method for attacking the habits that surround alcohol use. AA, in essence, is a giant machine for changing habit loops.” (1249-1251)
“And some aspects of the program are not just unscientific, they can seem downright strange. Take, for instance, AA’s insistence that alcoholics attend ‘ninety meetings in ninety days'— a stretch of time, it appears, chosen at random.” (1256-1260)
“Or the program’s intense focus on spirituality, as articulated in step three, which says that alcoholics can achieve sobriety by making ‘a decision to turn our will and our lives over to the care of God as we understand him.’” (1256-1260)
“In the past five decades, as almost every aspect of psychiatry and addiction research has been revolutionized by discoveries in behavioral sciences, pharmacology, and our understanding of the brain, AA has remained frozen in time.” (1264-1265)
“Their findings endorse the Golden Rule of habit change: AA succeeds because it helps alcoholics use the same cues, and get the same reward, but it shifts the routine. Researchers say that AA works because the program forces people to identify the cues and rewards that encourage their alcoholic habits, and then helps them find new behaviors.” (1271-1273)
“Take steps four . . . and five. ‘It’s not obvious from the way they’re written, but to complete those steps, someone has to create a list of all the triggers for their alcoholic urges,’ said J. Scott Tonigan, a researcher at the University of New Mexico who has studied AA for more than a decade. ‘When you make a self-inventory, you’re figuring out all the things that make you drink. And admitting to someone else all the bad things you’ve done is a pretty good way of figuring out the moments where everything spiraled out of control.’ Then, AA asks alcoholics to search for the rewards they get from alcohol. What cravings, the program asks, are driving your habit loop?” (1275-1283)
“In order to offer alcoholics the same rewards they get at a bar, AA has built a system of meetings and companionship—the “sponsor” each member works with—that strives to offer as much escape, distraction, and catharsis as a Friday night bender. If someone needs relief, they can get it from talking to their sponsor or attending a group gathering, rather than toasting a drinking buddy. ‘AA forces you to create new routines for what to do each night instead of drinking,’ said Tonigan. ‘You can relax and talk through your anxieties at the meetings. The triggers and payoffs stay the same, it’s just the behavior that changes.” (1289-1294)
“Asking patients to describe what triggers their habitual behavior is called awareness training, and like AA’s insistence on forcing alcoholics to recognize their cues, it’s the first step in habit reversal training. The tension that Mandy felt in her nails cued her nail-biting habit.” (1339-1341)
“However, those alcoholics who believed, like John in Brooklyn, that some higher power had entered their lives were more likely to make it through the stressful periods with their sobriety intact. It wasn’t God that mattered, the researchers figured out. It was belief itself that made a difference.” (1493-1495)
The excerpts below are also worth pondering. The first gives us a further glimpse of Charles Duhigg’s view of AA. The second shows his expertise on the subject. They are taken from an article Duhigg posted on his website on February 13, 2012, which you can read in full by clicking on the link. The “of” in the subtitle, by the way, should be read as “about.” The title is self-explanatory. If you don’t think it means what it seems to say, read the article. The irony is unintended.
Why Did Whitney Fail Rehab? Too Much Talent.
How the Science of A.A. Explains Whitney Houston's Death
“To understand why [12-Step programs failed Whitney Houston], consider the amateurish and completely unscientific origins of the first 12-step program, Alcoholics Anonymous.”
“Wilson would never have another drink. For the next thirty-six years, he would devote himself to building Alcoholics Anonymous by essentially making up – out of thin air – the rules that today help an estimated 2.1 million people each year.”
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