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  Moreover, applying the AA model can be problematic when the malady doesn’t lend itself to the dogmatism of the twelve steps. To use the most obvious example, the abstinence-only approach that sounds reasonable enough when the demon is alcohol becomes a tougher sell in a group like Sex and Love Addicts Anonymous (SLAA), where one is dealing with a pastime that you can’t reasonably expect people to foreswear now and forever.8 The result, in SLAA’s case, is a middle-of-the-road stance that incorporates most of the AA liturgy but also acknowledges that “there are no absolutes for sobriety in SLAA.” By its own admission, the organization hopes to promote a “healthy attitude” about sex at the same time that it decries promiscuity as a ruinous evil and refuses to specify just how much sex constitutes promiscuity. Members are even told to be wary of “sexual anorexia,” an unhealthy avoidance of sex that may result from an overreaction to the program.

  Some find these behavioral gray areas difficult to negotiate. Parallels have been drawn to the old Catholic-school enigma, wherein young girls learned that sex is both a “grievous sin that will destroy your life and send you to burn eternally in hell” and a “great blessing and a joy that you should one day bestow upon your husband lovingly and without hesitation.”

  Such problems highlight the complications that result when twelve-step programs are adapted to a vast array of problem behaviors or “dysfunctions.” If twelve-steps programs can’t be depended on to solve the tangible problems for which they were created, can they be counted on to help people cope with airy psychological constructs like “codependency” that can’t even be defined, let alone quantified.

  DYSFUNCTION BOULEVARD

  No matter how confusing its methods or its metaphors, and no matter how questionable its success rate, Recovery is here to stay. Based on nothing concrete, people who should know better will continue to call everything an addiction or dysfunction or disease so that they may then employ tactics that have never been shown to work. In part, says Franklin Truan, this has to do with a natural human need for mastery of one’s environment. “Having an answer to a problem, whether or not it is valid, gives the individual a sense of control over something that previously may have seemed uncontrollable,” he wrote in the Journal of Psychology. Money further complicates matters: “The perception of addiction as an incurable disease,” Truan continued, “provides the professional and lay community with the opportunity for unlimited and never-ending treatment, which has become a lucrative business.”

  For such reasons, we’re well served by taking a brief tour down Dysfunction Boulevard. Consider these five overlapping messages of the twelve steps and the Recovery movement.

  1. YOU’RE DAMAGED GOODS

  “Once, people used to shrug off a bad day as a bad day,” says David Blankenhorn, the founder and president of the Institute for American Values and the author of 1995’s controversial social critique Fatherless America. “No matter how bad things were on Monday, there was always Tuesday.” That uplifting sense of renewal is the very source of strength the twelve-step programs undermine, he told me: “Instead of just looking at ourselves as being in a rut, [the Recovery movement] teaches us to see ourselves as having a permanent condition of some sort. The condition becomes how we define ourselves.”

  There may be a way of rising above it, if you confess your weakness (steps 1 and 2 in the twelve-step paradigm) and entrust yourself to The Program and/or The Guru (steps 3, 6, and 7). But whatever is wrong with you will always be there, much like herpes, waiting to flare up again.

  As with any incurable disease, there are bound to be complications and side effects, some of which, we’re told, are every bit as bad as the principal malady. The litany of these secondary afflictions is lengthy and sobering: post-traumatic stress disorder, obsessive-compulsive disorder, other “opportunistic” addictions, to name just a few. It is often said that people raised in dysfunctional environments become prime candidates for substance abuse, spousal abuse (either as abuser or victim), overeating (“food addiction”), and so forth. The literature of Recovery tells us that abused children are far more likely to become sexually disordered adults, the specific manifestation depending on the parent who did the abusing and the nature of the abuse.

  Harvard’s Archie Brodsky says the movement’s self-fulfilling fatalism is clear in the lexicon: “People are always ‘in recovery.’ They’re never ‘recovered.’ ” This can lead to what some have called a “cop-out syndrome,” wherein people not only explain past failings in terms of their malady but also lay the groundwork for future failings: I’m an adult child of an alcoholic, so therefore what can you expect of me? What can I expect of myself?

  In support of such philosophical criticism, Brodsky cites a RAND study of adolescents attending Alateen meetings. Although the majority of the kids did show short-term improvements in schoolwork and overall “adjustment,” most settled back to their old ways within a year—and 36 percent actually did worse. “The seminars gave them psychological ‘permission’ to see themselves as failures,” Brodsky told me. “Before the seminars they were discouraged. After the seminars, they felt flawed.”

  2. GOOD IS BAD

  Despite the ferocious optimism embodied in the twelve written steps, the programs do not, in practice, accentuate the positive. A nihilistic view of life and living is stitched into the very fabric of Recovery. Convincing people who are “in denial” of the gravity of their condition and its dominion over their daily lives often requires a harrowing psychological battering from the group. Akin to what you sometimes see in “interventions” taken against substance abusers, this battering may entail constant retelling of their most regrettable moments (the sort of tedious immersion in self-loathing that led Jean Kirkpatrick to splinter off from AA) and/or coercive introspection in which members learn to see the hidden pathology beneath their unremarkable memories of childhood. “In the world of codependency,” Wendy Kaminer wrote in I’m Dysfunctional, You’re Dysfunctional, “families are incubators of disease: They manufacture ‘toxic’ shame, ‘toxic’ anger, ‘toxic’ self-doubts, and any number of ‘toxic’ dependencies. Codependency books lead you back through childhood to discover the many ways in which you’ve been abused and the ‘negative messages’ you’ve internalized. . . . Readers are encouraged to reconstruct their own pasts by drawing family trees (’genograms’) charting their legacies of abuse.”

  Says Brodsky, “It’s hard to overstate just how traumatic and psychologically destructive that single ‘revelation’ can be. You grow up loving and trusting your family, your parents. Now you’re told they were the source of the unhappiness or any lack of achievement in your life.” How, he asks, could that not play havoc with a person’s ability to trust other aspects of life that “seem good on the surface”?

  Their faith in even the most sacred of life’s institutions rudely shattered, many people emerge from Recovery skeptical and suspicious. As Kaminer has suggested, those raised on Recovery regimens often believe nothing, and believe in nothing. Recovery’s emphasis on discerning the covert patterns in behavior teaches twelve-steppers to catalog the bad things that happen to them under preconceived notions of Victimization and a supposedly hostile universe.

  To understand how Recovery theory can stand a good thing on its head, consider the spate of programs designed to combat “love addiction.” One popular program, Irresistible Chains, drives its followers, primarily young women, to a Web site that includes a subsection called “The Addiction Hits Campus.” Love is described as a “social dependency constellation,” a symptom of which is “the need to cling to one human object for love and support.” The site recounts the tragic saga of Jody Agler, an Indiana University student whose travails began when she met fellow student Jeremy Lantz and “had feelings for him immediately.” Eventually, through much counseling and soul searching, Agler learned to distrust the euphoric connection she felt with Lantz; she also learned that such connections may be counterproductive for her in general. The site goes on to quo
te Stanton Peele, a psychologist and addiction therapist who points out that some folks “devote their whole lives to one person, closing off all shutters and doors.” In fairness to Peele, he is not a fan of twelve-step theory. Still, he states here that love bears “a striking resemblance to drug use,” a theme the site reinforces again and again. Anne Wilson Schaef picks up the same disillusioning theme in such best sellers as Escape from Intimacy and Meditations for Women Who Do Too Much.

  3. IT’S ALL ABOUT YOU

  It has been observed that people in codependency workshops are not the nicest folks to be around. That’s because anticodependency therapy comes across as an endorsement of selfishness.

  “To the extent that it works at all, it has to be criticized for causing an overreaction away from caring about other people,” Steven Wolin, a professor of psychiatry at George Washington University, told me. “The ‘recovering codependent’ tends to keep people at arm’s length. It’s a classic pattern. They go from one extreme to the other, and if you confront them on it, they’ll tell you, ‘Well, I’m better off looking out for myself.’ ” Wolin says he isn’t always so sure.

  The so-called Me Generation of the 1980s already had worked up a head of steam by the time Melody Beattie’s Codependent No More burst on the scene. “Many factors played into the deteriorating marriage climate in the 1970s and 1980s, of which the Recovery movement was just one,” says the social scientist James Q. Wilson, whose classic work of social commentary, The Moral Sense, deals in large part with the breakdown of American institutions over the past half century. But there’s no question that Beattie’s 1987 book was a perfect fit with the zeitgeist or that some people embraced its arguments who shouldn’t have. At the height of self-determination fever, some women, filled with a sudden need to escape the drudgery of day-to-day life, began walking out on their “unsatisfying” marriages (and sometimes their blameless, wide-eyed children). The 1980s featured the highest average divorce rate of any decade in American history, never dipping below 4.7 percent per 1,000 population. That’s about double what it was in 1955. (In the next chapter we’ll see in more detail how SHAM has adversely affected marriage and relationships.)

  4. ALL SUFFERING IS CREATED EQUAL

  When an influential voice like John Bradshaw draws outrageous analogies between children of alcoholics and Holocaust survivors, he encourages a loss of perspective that isn’t helpful in a society struggling to fine-tune its moral bearings and rank its collective imperatives. Reacting to the Bradshaw argument, David Blankenhorn says, “Having annoying or even emotionally dysfunctional parents is not the same as physical abuse. An occasional episode of spanking cannot be compared to living through the Holocaust.”

  It can be argued that pain is pain—that when you’re hurting, it matters little whether others consider your pain trivial in the grand scheme of things. This argument, in fact, underlies so much of Recovery. As noted in point 3, it’s all about you. You’re allowed to think of your own needs, to put yourself first. On the other hand, it does matter to society that so many of its supposed citizens have devolved into whiny, Seinfeldian solipsists who rank their fondness for “emotionally unavailable” lovers on a par with world hunger. “The process of coming to adulthood is about learning to make value judgments and assign priorities,” James Q. Wilson told me. “It’s about seeing yourself in the context of something larger than yourself and your own selfish needs.”

  One would think a key ingredient of personal growth and emotional health is the ability to understand gradations of suffering, to develop a certain resiliency in dealing with disappointment, to discern the all-important distinction between needs and mere wants.

  Yet to hear the folks in Recovery tell it, an individual’s quest to have his private pain validated is the single most deserving enterprise on the planet. “It’s beyond navel contemplation,” says one psychiatrist who asked not to be quoted in this connection. “It’s asking other people to feel sorry about the lint you find there, and then to help you remove it.”

  The ironic (and often, for the Recovery groups themselves, self-defeating) result of this psychosociological free-for-all is a kind of desensitization. After listening to the complaints from drunk people, fat people, sad people, oversexed people, incest survivors, divorce survivors, people who can’t get a date, people who wish they could stop dating partners who hurt them, and on and on, we become jaded. Sick of trying to sort through the mess, we begin to assess the various (self-)interest groups without meaningful regard to the merit of their claims; we simply assign the greatest value to the squeakiest wheel.

  5. IT’S NOT YOUR FAULT

  Some years ago I began surveying my college classes on their feelings about the Clinton presidency. Did Bill Clinton’s romantic indiscretions—and his subsequent lies about them—in any way reflect on his fitness to govern? Resoundingly, semester after semester, my students said no. It is true that college students, on average, take a more bohemian approach to life than most people and thus are more inclined to shrug off promiscuity. But their reasoning intrigued me. I recall one young woman who casually explained, “Women were his weakness, that’s just how it was. I don’t think he could control it.” And the lying? “Well, what do you expect the guy to do? Admit it in front of his wife and the nation?”

  A male student chimed in: “People always try to cover up for the bad things they do, don’t they?”

  My unscientific classroom polls hinted at the outlook with which those students grew up, and which is now rampant in society: Each of us has some weakness, something inside us we can’t control—and that’s how it is. What’s more, since nobody wants to admit a weakness, well, what else are you gonna do but lie? Why, it’s just plain common sense!

  If that sounds plausible, ask yourself how far you’re willing to take that logic. What about Ted Bundy’s “weakness”? The boys at Enron? Were Uday and Qusay Hussein suffering from “damaged inner-child syndrome”? (I’ve purposely taken the argument to extremes, because Victimization theories have been employed as murder defenses in this country.) Once you start making allowances based on people’s weaknesses, where do you draw the line? And who gets to draw it? If a person has no power over his or her weakness, how does society credibly decide whose weakness is tolerable and whose isn’t? Having gone that far, how does society justify blaming people, much less punishing them, for acts that are beyond their control?

  A popular answer: We draw the line where society gets hurt.

  But we do not draw the line where society gets hurt. Not consistently, and not neatly, either. Often we draw that line based on how well blocs of people with a shared “weakness” have sold their message of Victimization and self-disciplinary impotence. Let’s return once more to that original class of victims. Though America finally shows signs of reaching the limit of its patience with drunk drivers, it was not always thus. In 1967 the American Medical Association (AMA) burst forth with its revisionist conception of alcoholism as a disease. This did not happen out of the blue. Alcoholics Anonymous and leading psychiatric organizations, as well as factions of the legal community, had long been pressuring the medical community to give alcoholism a biological underpinning.9

  For the first half of the twentieth century, alcoholics were handled more under the criminal model than the patient model; they were thrown into drunk tanks rather than tucked into beds in emergency rooms. If and when they did land in hospitals, they were commonly treated as “charity cases,” with the cost of their care often coming directly out of a hospital’s bottom line. There was no formal mechanism for obtaining insurance reimbursement of any sums hospitals spent on the care of alcoholic-related disorders. More important, society’s unsympathetic view of the affliction left doctors with little basis for urging health insurers to set up or subsidize rehabilitation plans. The AMA’s revised stance, in essence, took substance-abuse therapy out of the exclusive province of private groups like AA and made it mainstream. It also allowed psychiatrists and psychologi
sts to submit for reimbursement for whatever counseling and therapy they provided to addicted patients. While many of those in the vanguard of this movement meant well, one cannot overlook the more venal motives on the part of at least some of those among the AMA establishment who represented the hospital interests and certain medical specialties. Put bluntly, they saw the unrealized profit potential in alcoholism.

  Today, on any given day, seven hundred thousand Americans receive treatment related to alcohol abuse or dependency. As a rule, this care is either fully reimbursed by individuals’ insurance or underwritten by blanket policies carried by employers. In addition, a major 1998 survey pegged the direct cost of alcohol’s medical consequences at $18.9 billion, much of which, again, is now covered under health insurance. The AMA policy also opened the door to pharmacological approaches to treating alcoholism, as well as still more insurance reimbursement of sums spent on drugs such as disulfiram and naltrexone.

  In sum, an entire new industry-within-an-industry has sprung up—all based on little or no hard evidence, especially none that existed in 1967.

  “It is astonishing how far some of my colleagues have gone in stretching the limits of what we really knew about the mechanism of substance abuse, which isn’t much,” Sally Satel told me. She is especially critical of those doctors and medical researchers who were the earliest voices in positing an “alcoholism gene.” “There is no peer-reviewed evidence for any such conclusion,” she says. “Reputable medical institutions that in any other setting would never dream of committing themselves to a position without hard science nonetheless leaped on the bandwagon when it came to this one subject.”