About the Concept of Powerlessness in Alcoholism and Substance Abuse

Step 1. We admitted we were powerless over alcohol – that our lives had become unmanageableAlcoholics Anonymous

The famous first step of Alcoholics Anonymous has acquired many admirers and detractors over the years. I find this to be fascinating because how one feels about the “first step” is a strong predictor of whether or not a person will find help using AA.

AA and it is spin-offs eg Narcotics Anonymous, has many advantages for those seeking help with drinking problems. The organization is well established and has worked for many, but by no means all, of those who become regular attendees. It has by far the largest number of meetings on the planet. It is member run and is anonymous- there are no forms to complete to join, just a desire stop drinking.

And yet many people don’t attend for a variety of reasons. Some people are put off by the spiritual basis of the organization with its Christian background. Some people are not   ready to admit they need help because they either don’t accept what others recognize, i.e. that they have a real problem. Or they might recognize that they are hurting, but are unwilling to deal with it because AA advocates abstinence. Others are physically addicted to alcohol and may have end stage alcoholism. If they suddenly stop drinking they could end up in DTs and even die. Of course many of these folks are destined to die from drinking one way or another.

And some people are just put off by the very 1st step admitting to being powerless over alcohol.

When I mention people who object to the idea of being powerless over alcohol or drugs, I am not referring to those in denial and who could easily object to any aspect of AA. No, I refer to those who would make an argument that they are philosophically or intellectually opposed to the concept of powerlessness.

The basis for people who have trouble with the powerlessness concept in AA.

Here are some of the arguments put forward by those who dislike speaking about powerlessness and alcohol/substance addiction. Some people feel that by promoting the idea that one has no control over alcohol there is a convenient excuse for any slip or resumption of use. Personal responsibility is abdicated because one has a disease or can’t help using because they are powerless.

Some take this point to what they see as its logical conclusion. If people are truly powerless, then any help of any kind would be futile by definition. For an example of this viewpoint plus a stirring account of someone who gets sober without AA see the following link for an article by Paul Carr, author of the book,  ”Sober is my New Drunk.”

http://online.wsj.com/article/SB10001424052702304692804577281413725296538.html

Another variant regarding this line of thinking comes from Rational Recovery which posits that both powerlessness and the disease model of alcoholism promote alcohol use by strengthening the voice of the “inner addict.”

In a way this seems like silly semantics to me because many of the people who find the powerlessness construct distasteful or even harmful still advocate for abstinence.

Powerlessness paves the way for the spiritual component of AA which immediately presents itself in Step 2. We came to believe a Power greater than ourselves could restore us to sanity. For anyone who might have been on the fence about the concept of powerlessness, but who is also prone to rejecting  the heavy religious and spiritual overtones of AA, then step 2 will likely bounce them out of considering attendance.

An offshoot to this point is the indictment by implication that someone who is an alcoholic is in a state on the far side of sanity, not something everyone is willing to embrace.

I think there is a subset of people, both male and female, who have an underlying psychological issues either predating alcohol and substance abuse or resulting because of excessive use. These people may be vulnerable to narcissistic injury. They are sensitive to perceived slights and stigma embedded in concepts such as powerlessness, insanity, and weakness because they lack the ability to control their behavior.

Such people may also be extremely sensitive to be seen by others as being defective. Sometimes people will perversely continue to drinking or use drugs because to stop would be to admit that they were indeed flawed.

Still another a line of reasoning against powerlessness comes those using a  feminist, sociological critique. These observers have noted the origins of AA coming from a certain group of white males in the 1930s, notably AA founder Bill Wilson, an unemployed stock broker and Bob Smith, a surgeon. It is argued that the heavy ego deflating components was used to combat a more male oriented arrogance exhibited in great quantity by these early AA members. Not that such qualities still aren’t found in alcoholics today. However many contemporary women already suffering from disempowerment in their families, jobs, and religious institutions are ill served by being subject to messages that they have too much power in their lives. In this analysis, their drinking could be an escape from the lack of power they experience in their lives.

Potentially helpful aspects of the powerlessness concept.

I’d like to make a few observations about what I consider to be useful about the powerlessness toward alcohol concept.

First, many people struggle even getting into the door of a first AA meeting. Studies have found that on average that of the people who actually attend an AA meeting it takes them 14 months from the time it was first suggested. Many people find it a big relief to become part of an organization that embraces a disease concept re drinking problems. The whole ethos of AA is that people are not to be blamed for being alcoholic. This encourages people to reconsider their own self -blame regarding their drinking problem.

AA stresses that even though people are not to be blamed for being alcoholic that this does not absolve them of responsibility for their recovery.

Other positive aspects to the concept of powerlessness include that if people truly comprehend that they have no power over alcohol in the sense that they cannot control their drinking, then on a very important level they get what their problem is, the nature of it, and why they must chose abstinence. If people can accept they are powerless, then they are not in denial that they have a problem or what course their recovery needs to take.

Lastly, when I work with people dealing with alcohol and substance issues, a key consideration is loss of control. If someone vows to have one drink but winds up in a blackout or otherwise obliterated, then as far as I am concerned they are powerless over alcohol.

As they say in AA, “One drink is too many and a hundred’s never enough.”

If this way of characterizing their problem doesn’t work, then there are many other ways of describing the issue. If they are coming to therapy for help with their drinking, my job is to provide pathways toward recovery. I may be diplomatic or I may mince no words. Our task is to find something helpful using whatever social support, adjuncts, concepts, or tools that are available.

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