Sunday, September 09, 2007

12 steps to mind rape

The ninth circuit court has recently ruled that you can't force someone to go to a 12 step program against their will, as a condition of their release; because it is in effect forcing someone into religious indoctrination under the color of governmental authority.

For those of you who have been living in a cave since the late 60s, the 12 step idea is that addicts should admit they are out of control and surrender themselves to a higher power, asking that higher power to help them control their addiction through spiritual awakening.

These are the steps:
1. We admitted we were powerless over alcohol--that our lives had become unmanageable.

2. Came to believe that a Power greater than ourselves could restore us to sanity.

3. Made a decision to turn our will and our lives over to the care of God as we understood Him.

4. Made a searching and fearless moral inventory of ourselves.

5. Admitted to God, to ourselves and to another human being the exact nature of our wrongs.

6. Were entirely ready to have God remove all these defects of character.

7. Humbly asked Him to remove our shortcomings.

8. Made a list of all persons we had harmed, and became willing to make amends to them all.

9. Made direct amends to such people wherever possible, except when to do so would injure them or others.

10. Continued to take personal inventory and when we were wrong promptly admitted it.

11. Sought through prayer and meditation to improve our conscious contact with God, as we understood Him, praying only for knowledge of His will for us and the power to carry that out.

12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.
Though AA (and other 12 step programs) will say they are not religious; they do specifically refer to the "higher power" and "god, as we understand him" etc... Also, it is an explicitly proselytizing philosophy as described in step 12.

Many will even say that the "higher power" can be anything or anyone, and doesn't have to mean god; though given the content of the steps, such an assertion is ridiculous on its face.

I am a catholic man, raised in the church, gone from it for 15 years and returned by choice, because of my faith in god, and my personal experience with christ. I know the power of faith; but I also know that faith comes from within, it cannot be forced on someone. Attempting to do so is both ineffective, and I believe offensive to god (and man).

Further though, this is a greater issue than whether AA is religious or not. This is an issue of self determination and freedom of conscience; and honestly an issue of efficacy as well.

Let's address that efficacy issue first.

You can't coerce someone into any kind of therapy (which is what rehab programs are, as opposed to de-tox) and expect it to be effective.

I come from a family of alcoholics and drug addicts; and the most important things about addicts to understand are:
1. They are ALWAYS an addict, even if they get it under control

2. Their addiction is ALWAYS going to control them, for the rest of their lives. It is only when they are strong enough to fight back that they will be able to maintain control.

3. They have to WANT to maintain control for it to work, and for it to keep working. They have to want it, more than they want their addiction.
That goes for any addiction; be it alcohol, drugs, sex, or self hatred (perhaps the strongest, easiest to acquire, and hardest to kick addiction).

Now, some might make the argument that we have a duty to protect society from these peoples behavior, and that they are better off in treatment than in jail... and to some extent there is a valid point there (assuming we are in fact punishing and preventing BEHAVIOR, not morality), but it presumes that treatment is an effective means of accomplishing this goal.

I wont say that treatment doesn't work. I have friends and family members whose lives have been saved with the help of treatment programs; and I'm convinced without that help, they would be dead. It can work for some, IF THEY ARE READY AND WILLING.

The best estimates (and they are very sketchy estimates indeed; complied by epidemiologists, and addiction psychologists from public patient records and sample interviews) on the success of ALL treatment programs, be they secular, non-secular, inpatient, outpatient, whatever; is about 10% on the first try.

Yes, there is a 90% relapse rate; and I'm not talking about slipping and having a drink or a toke. 90% of addicts who enter a recovery program return to an addict lifestyle for an extended period of time.

It's about 50% on the second try. Generally speaking, if someone collapses back, and then manages the will to go again, they mean it this time; and they do well.

The relapse rate climbs back to about 65% by the third try, and if they haven't got it by then, the numbers fall off dramatically, to the point where someone in their 4th or 5th visit to rehab has nearly a 100% relapse rate.

The funny thing is, these numbers also hold true for people who try to quit on their own without treatment. About 90% fail the first time, 50% the second time, and returns diminish from there.

This isn't to say that treatment is completely ineffective, or no more effective than recovery without treatment. Most addicts don't have the will to do it by themselves, without the support structure of treatment; and even the very strong have weak moments, where that support can help them avoid relapse.

Also, often people come to treatment and succeed in it, after trying and failing on their own several times; because the structure of treatment helped them as above.

That means that though the percentages are the same, the absolute numbers of successful treatment from a program vs self guided, are much higher.

What's most telling though, is that these numbers seem to hold true, no matter what the treatment technique, no matter who's doing the treatment; because treatment isn't about the program, it's about the addict.

Let me say that one more time: success in controlling addiction isn't about the program, it's about the addict.

Now, back to the more important question,the morality of forced treatment.

I will make a blunt and harsh statement here that may offend some: Coercing someone into changing their very thoughts, is one step away from rape; and I mean no hyperbole in that.

If one must successfully complete a treatment program (or in fact any kind of therapy, indoctrination, or "thought modification" program) to remain free; and a part of the program forces you to do, say, or support that which you do not believe in; that is simply wrong. The state should not be in the business of policing thought. We MUST have freedom of conscience, as free people.

That said, if someone is given a sobriety order (which I think is very rarely justified, but that's another argument entirely) and they violate it; back in jail they go. I have no problem with that. That is a behavioral remedy, and requiring people modify their behavior to avoid harming those around them (presuming that is the true purpose, rather than the belief that substance abuse is immoral) is a fundamental part of civilized society.

The remedies of our justice system MUST only be behavioral; once law dictates conscience, we are nothing but slaves. One must hope that through behavioral remedies we can aid people in coming to a less harmful thought pattern and lifestyle, but we cannot force them to think or feel as we wish.

So, I have no problem with a court ordered de-tox, or court ordered and enforced sobriety (including returning them to prison as a penalty) under appropriate circumstances; and if someone VOLUNTARILY wishes to enter treatment to prevent that from happening, I'm all for it. Ordering someone into therapy though, is both ineffective, and a violation of the fundamental human right of freedom of conscience.

We may want people to change, we may even require them to change their behavior, or be punished; but we cant force them to change their thoughts and feelings. It is, at it's core, mind rape; any way you care to justify it.