Sham Read online

  My intent is not to trivialize or explain away the genuinely awful things that do happen to innocent people. Rather, my purpose is to establish that in the normal course of American life, truly awful things happen to comparatively few of us. That is by definition. If it were not the case, “we probably wouldn’t consider such things ‘awful’ in the first place,” says psychiatrist Sally Satel. We would not react to stories of horrific abuse with as much shock and outrage because, for better or worse, we would view such events as “business as usual.” When the aberrational becomes commonplace, it is no longer aberrational. It is simply life. In reality, many of the episodes and practices Victimization taught us to regard with loathing—maybe your father spanked you a bit, or your mother took a drink or two—really are, or were, just part of growing up.

  You’d never know that from the titles of the movement’s signature works: Toxic Parents: Overcoming Their Hurtful Legacy and Reclaiming Your Life, The Doormat Syndrome, and Raising Children in a Socially Toxic Environment. If you’re in decent shape yourself, there’s always the problem of interacting with the dysfunctionals around you: Toxic Coworkers: How to Deal with Dysfunctional People on the Job; Coping with Toxic Managers, Subordinates, and Other Difficult People; and I Thought I Was the Crazy One: 201 Ways to Identify and Deal with Toxic People.

  As you can see, they’re big on toxicity in Recovery circles. And they’re huge on shame; thousands of self-help books have focused directly on the concept. Notable among them: Soul without Shame: A Guide to Liberating Yourself from the Judge Within; Shame and Grace: Healing the Shame We Don’t Deserve; Letting Go of Shame; Shame: The Power of Caring; Shame and Guilt: Masters of Disguise; Facing Shame: Families in Recovery; Released from Shame: Moving Beyond the Pain of the Past; Women and Shame: Reaching Out, Speaking Truths, and Building Connections; Fear and Other Uninvited Guests: Tackling the Anxiety, Fear, and Shame That Keep Us from Optimal Living and Loving; and—in the category of “all-time longest and most unwieldy title built around a single concept”—I Can’t Believe I Just Did That: How Seemingly Small Moments of Shame and Embarrassment Can Wreak Havoc in Your Life—and What You Can Do to Put a Stop to Them.

  Plenty of other books have been devoted to codependency, a concept that is widely misunderstood, perhaps because the explanations advanced for it defy understanding. In the bible of the movement, Codependent No More (1987), Melody Beattie defined the codependent as “one who has let another person’s behavior affect him or her”—which doesn’t exclude too many of us—“and who is obsessed with controlling that person’s behavior” (which probably describes all of us at some time in life). The trouble is, anyone who does not spend his or her life in a cave is bound to care for, or depend on, other human beings, at least to some degree, and the ensuing emotional bond will not always produce happy results. Beattie’s definition, moreover, hinges on a precise and delicate common understanding of the words obsessed and controlling. No such consensus exists, “or likely is attainable,” writes John Rosemond, a psychologist and syndicated columnist.2

  Despite such ambiguities, Codependent No More at one point spent a hundred consecutive weeks on the New York Times best-seller list, selling some two million copies. Anne Wilson Schaef’s Meditations for Women Who Do Too Much (1991), which offered its own slant on codependency, sold more than four hundred thousand copies. My personal favorite in this crowded field is Codependency Sucks, by Linda Meyerholz, MS, which shows a feral, manic-looking man who appears on the verge of throttling a very pained-looking woman. The book is published by Love ‘n’ Support Publishing.

  Nor was this necessarily a girlie thing. John Bradshaw’s Bradshaw On: Healing the Shame That Binds You sold some eight hundred thousand copies, persuading a generation of men that they, too, were entitled to feel crappy about themselves and their upbringing. It was Bradshaw who popularized the notion of the inner child and who gave American culture the downbeat neologisms rage-aholic and toxic shame (the latter, perhaps, under the theory that if the two words resonated so well individually, why not seek a synergistic effect?). And there was Robert Bly, National Book Award–winning poet (in 1968) and self-proclaimed “father of the expressivist men’s movement,” who in 1990 penned Iron John: A Book about Men. The book is a quasi-allegorical folk tale in which the title character leads readers, presumably men, on a journey of gender- and self-discovery. What male readers mostly seemed to discover was that they were sick of being nagged by women and stereotyped by feminists. Iron John became a touchstone for disaffected men, almost surely making them far more resentful of women and feminism than they ever needed to be. It also made Bly a top draw in the workshop movement (though Bly himself, it should be noted, disavowed the book’s more misogynistic interpretations).3

  For many Americans, books and informal workshops haven’t been enough. American Demographics reported in March 1992, at Recovery’s peak, that twelve million Americans were attending meetings of at least one of the nation’s half-million support-group chapters. Still today, more than a decade after the publication of Marianne Williamson’s A Return to Love: Reflections on the Principles of A Course in Miracles, seminars by the high priestess of New Age fulfillment sell out almost as quickly as Clay Aiken concerts, as do the $150 workshops run by John Bradshaw. As Archie Brodsky, a senior research associate in the Program in Psychiatry and the Law at Harvard Medical School, told me, “For certain individuals, this whole self-help and Recovery phenomenon is more potent and addicting than any narcotic. People’s appetite for this stuff is unquenchable.” Hence Recoveries Anonymous, which describes itself as a “Twelve Step program . . . especially for those who, despite their best efforts, have yet to find the recoveries that they are looking for.” In other words, if you’re not quite sure there’s anything wrong with you, don’t despair—we’ll find something.

  In sum, Victimization and Recovery have relentlessly encouraged ordinary people with ordinary lives to conceive of themselves as victims of some lifelong ailment that, even during the best of times, lurks just beneath the surface, waiting to undo them.

  Needless to say (though almost nothing commonsensical is “needless to say” in the context of SHAM’s teachings), it is not automatically dysfunctional to face life with assorted traumas and trepidations our parents imbued in us as children. On the contrary, it is entirely functional to fear certain things, for such fears help safeguard us from pain, humiliation, and even death. In any case, as Sally Satel and other vocal critics of Recovery will tell you, we’re not children anymore. Today as never before, perhaps—given the genuinely apocalyptic threats unfolding around us—Americans have an obligation to themselves, their families, and society to quit whining, stop comparing notes on who is more diseased, addicted, or dysfunctional, and just tend to business.

  Recovery exhorts Americans and America to do just the opposite, creating whole new categories of addictions and diseases for which there is often little, if any, foundation. “Psychology continues to support disease models of addiction despite an inadequate research base,” Franklin Truan, a clinical psychologist, observed in the Journal of Psychology. Speaking of alcoholism specifically, Michael Hurd told me, “At best, the ‘disease’ concept is a loose metaphor.”

  What’s more, the Recovery ethic strongly implies that a genetic predisposition exists for whatever ails us. In the case of the physical dependencies—alcohol, drugs, eating, smoking—this genetic component frequently is stated outright. A much-quoted study of overeating, for example, refers to a person’s physical size as his or her “biological destiny.” In making these declarations, Recovery leaders seem undeterred by the fact that “the scientific foundation for these sweeping assertions is flimsy at best,” Satel told me.

  No matter how flimsy the evidence, by dint of sheer repetition the message spun by Recovery’s champions has won over the American public: A 1997 Gallup poll showed that almost 90 percent of respondents regarded alcoholism as “a disease.” Interestingly enough, another 1997 poll, this one
among physicians who actually treat alcoholics, showed that 80 percent of the doctors thought alcoholism was plain old bad behavior.4 But amid the ongoing national mood of empathy, understanding, and political correctness, that is not the kind of poll that gets headlines.

  MUCH ADO ABOUT . . . WHAT, EXACTLY?

  Perhaps the most striking feature of SHAM’s Recovery wing is the mainstream credibility it enjoys despite the dearth of evidence supporting it. The questions start with the progenitor of all Recovery, Alcoholics Anonymous, with its 2.2 million members worldwide.

  If we are to believe AA itself, then yes, its program would seem to offer some benefit. The organization quotes a success rate of about 40 percent, which traditionally has been considered admirable, given the thorniness of the problem. But there is no shortage of observers, among them former AA members, who allege in opinion pieces and widely read Web logs (blogs) that AA plays fast and loose with its numbers. (Try, for example, www.orange-papers.org or www.brothersjudd.com/blog/archives/009208.htm.) Even government agencies, including the National Institute on Alcohol Abuse and Alcoholism (NIAAA), have had a hard time puncturing AA’s wall of secrecy and anonymity.

  “It’s been a very difficult group to study,” Ann Bradley, a former alcoholic and now NIAAA’s resident authority on relevant analyses, told me. “It’s really something we still don’t know a great deal about.” Bradley says she does see signs that AA is “becoming somewhat more cooperative in working with outsiders.”

  In its official posture on AA, NIAAA treads lightly. Its overview of the program says, “Although AA is generally recognized as an effective mutual help program for recovering alcoholics, not everyone responds to AA’s style or message, and other recovery approaches are available.” The agency also concedes that AA’s “efficacy has rarely been assessed in randomized clinical trials.”

  Others have been more forthright in challenging AA’s effectiveness. In October 1995 the Harvard Mental Health Letter, a publication of the esteemed Harvard Medical School, pegged the spontaneous cure rate among alcoholics—the percentage who shake the addiction on their own—at between 43 and 82 percent, depending on the study criteria. As many as one-third of those, Harvard reported, were able to give up booze cold turkey. In short, Harvard’s research indicated that alcoholics who don’t try AA have a better chance of kicking the habit than alcoholics who do.

  If Harvard’s ranges seem a bit wide and the numbers a bit imprecise, consider what NIAAA’s Bradley told me: “In 1994 we reviewed all of the research to that point—125 different studies!—and it was like apples, oranges, grapefruits, and bananas. People had used so many different measures of the disease, and what constitutes addiction, and what constitutes dependency, and what constitutes being cured.” Bradley describes sorting through the morass of discordant data as “the most awful experience of my life.”

  Still, there is further evidence for the notion that recovery-minded individuals might be better off skipping AA or derivative programs. The ambitious work of the behaviorist Stanley Schacter suggests that individuals who try to lose weight or stop smoking on their own are more successful than those who try formal twelve-step programs. Indeed, in study after study, decade after decade, the demonstrable results of Recovery regimens—90 percent of which are based on AA’s storied twelve steps, according to the American Psychological Association—have been inconclusive at best. In his exhaustive 1983 work The Natural History of Alcoholism, Dartmouth psychiatrist George E. Vaillant looked at four decades’ worth of clinical trials and added an eight-year study of his own. He concluded that no evidence indicated that treatment of alcoholism in any form yielded better results than an individual could achieve just by letting the addiction run its course. Vaillant’s conclusions drew angry denunciations in Recovery quarters, but they have never been scientifically refuted. Discussing the voguish treatments for various physical addictions, Franklin Truan observed, “None of the models presented is more effective than others or more effective than no treatment.”

  It’s also hard to ignore an analysis first published in the American Journal of Psychiatry in August 1967. Researchers followed 301 people who had been arrested for “public drunkenness” in San Diego and were randomly assigned to three groups based on the nature of the court-ordered follow-up: no treatment, referral to professional counseling, or Alcoholics Anonymous. Finishing dead last—with almost 50 percent rearrested during the following year—were the eighty-six individuals sentenced to AA. Second best was the group receiving the counseling. And most successful at staying out of jail? Those receiving no treatment at all. Now that’s self-help.

  Whatever the initial cure rates may be, eventual relapse after treatment is shockingly high—between 50 and 90 percent, depending on the addiction and the study. For starters, we know that a fair number of people—possibly more than half—listed among Bill W.’s “First 100,” that inaugural class of AA members, fell off the wagon and/or died within a short time after being “cured.” Other accounts put the “First 100” itself at fewer than forty core individuals.5

  Such evidence lends credence to allegations that by characterizing addictions as “lifelong diseases,” AA-based platforms actually lay the groundwork for their own failure. If Alcoholics Anonymous has been adept at persuading society of any one thing, it’s that even after an alcohol abuser stops drinking, he or she remains a “recovering alcoholic” or “dry alcoholic.” One of the most eloquent critics of the twelve steps, Michael J. Lemanski, writes in the Humanist that such programs “offer what is, in reality, the antithesis of therapy. There is no cure.” In any case, research through the years has cast doubt on the cardinal AA belief “once an alcoholic, always an alcoholic.” Studies by the RAND Corporation and by separate Scottish and Swedish teams, among others, have uncovered a sizable percentage of former alcoholics who reverted to social drinking without also reverting to lives of chaos and heartbreak.

  The knowledge base on addiction and recovery surely would be far deeper had not AA, throughout its history, vigorously opposed independent research that sought to test its premises. For their aggressiveness in stamping out critical thinking even among members, AA and its sister organizations have invited comparisons to cults.6 Lemanski has described AA’s materials as follows: “The reader is told that, within meetings, only Al-Anon ‘conference approved’ literature can be read and discussed; sources of information from outside the program are not to be used because they ‘dilute’ the spiritual nature of the meetings. . . . Therapy, therapists, and professional terminology are also taboo,” a position that frustrates group members who desire to supplement their twelve-step efforts with input from medical or mental-health professionals. Many addicts find such outside reinforcement essential. The scientific journal Alcoholic Research and Health conceded in 2000 that “AA affiliation without professional treatment has not routinely resulted in improvement.” On its Web site, the National Institutes of Health notes that “even people who are helped by AA usually find that AA works best in combination with other forms of treatment, including counseling and medical care.”

  That observation is not surprising amid mounting evidence that alcoholism is seldom a problem unto itself but rather may have a root in depression or anxiety. In 2004 NIAAA released the results of what it describes as the “largest ever” study of the “co-concurrence of psychiatric disorders among U.S. adults.” The study revealed a significant overlap between people suffering from alcoholism and people suffering from mood or anxiety disorders. Extrapolating from its representative sample of 43,000 Americans over age eighteen, NIAAA estimated that many of the 19.4 million Americans who meet the diagnostic criteria for substance-abuse disorders (alcohol, drugs, or both) are also among the 19.2 million Americans who meet the criteria for such mood disorders as clinical depression and manic disorders and/or the 23 million who suffer from such anxiety disorders as panic attacks, phobias, and generalized anxieties.7 For the many people in those overlapping groups, it is doubtful that AA a
lone would work.

  Even so, when AA fails to bring about the desired results, the organization projects blame back on the sufferer—a common ruse in the world of self-help. “If an individual in AA, for one reason or another, doesn’t make adequate progress, the typical view is that he or she isn’t adequately ‘working the program,’ ” writes Lemanski. “The usual prescription, then, is to attend more meetings. The program can never be the problem.” (Another way of looking at it is that while Victimization doctrine holds that your problem is not your fault, if you can’t overcome that problem using the sanctioned twelve steps, well . . . it’s your fault.)

  AA’s defensiveness and inflexibility has created ample room for other groups to enter the Recovery market. Women for Sobriety (WFS) presents a typical case history. Now a 150-chapter organization based in sleepy Quakertown, Pennsylvania, WFS was formed in 1975 by Jean Kirkpatrick, a heavy drinker who had drifted in and out of AA for decades (not to be confused with the former ambassador to the United Nations). Kirkpatrick, who died in 2000, was unhappy not only with AA’s decidedly male tenor but also with some of the core aspects of the organization’s philosophy. “In AA meetings, they rehash their drinking stories over and over,” WFS administrator Becky Fenner told me. “I think that kept bringing up so much guilt in Jean that it actually made her feel worse. She wanted to get beyond the horror stories and the guilt.” Further, says Fenner, “At Women for Sobriety, we don’t have a higher-power concept. We encourage our women to take full responsibility for their own actions, instead of turning it over to something in religious or spiritual terms. We want them to work on their own self-worth.”