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An exposé of Alcoholics Anonymous, 12-step programs, and the rehab industry—and how a failed addiction-treatment model came to dominate America.   AA has become so infused in our society that it is practically synonymous with addiction recovery. Yet the evidence shows that AA has only a 5–10 percent success rate—hardly better than no treatment at all. Despite this, doctors An exposé of Alcoholics Anonymous, 12-step programs, and the rehab industry—and how a failed addiction-treatment model came to dominate America.   AA has become so infused in our society that it is practically synonymous with addiction recovery. Yet the evidence shows that AA has only a 5–10 percent success rate—hardly better than no treatment at all. Despite this, doctors, employers, and judges regularly refer addicted people to treatment programs and rehab facilities based on the 12-step model.   In The Sober Truth, acclaimed addiction specialist Dr. Lance Dodes exposes the deeply flawed science that the 12-step industry has used to support its programs. Dr. Dodes analyzes dozens of studies to reveal a startling pattern of errors, misjudgments, and biases. He also pores over the research to highlight the best peer-reviewed studies available and discovers that they reach a grim consensus on the program’s overall success.   But The Sober Truth is more than a book about addiction. It is also a book about science and how and why AA and rehab became so popular, despite the discouraging data. Dr. Dodes explores the entire story of AA’s rise, from its origins in early fundamentalist religious and mystical beliefs to its present-day place of privilege in politics and media.   The Sober Truth includes true stories from Dr. Dodes’s thirty-five years of clinical practice, as well as firsthand accounts submitted by addicts through an open invitation on the Psychology Today website. These stories vividly reveal the experience of walking the steps and attending some of the nation’s most famous rehabilitation centers.   The Sober Truth builds a powerful response to the monopoly of the 12-step program and explodes the myth that these programs offer an acceptable or universal solution to the deeply personal problem of addiction. This book offers new and actionable information for addicts, their families, and medical providers, and lays out better ways to understand addiction for those seeking a more effective and compassionate approach to this treatable problem. 


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An exposé of Alcoholics Anonymous, 12-step programs, and the rehab industry—and how a failed addiction-treatment model came to dominate America.   AA has become so infused in our society that it is practically synonymous with addiction recovery. Yet the evidence shows that AA has only a 5–10 percent success rate—hardly better than no treatment at all. Despite this, doctors An exposé of Alcoholics Anonymous, 12-step programs, and the rehab industry—and how a failed addiction-treatment model came to dominate America.   AA has become so infused in our society that it is practically synonymous with addiction recovery. Yet the evidence shows that AA has only a 5–10 percent success rate—hardly better than no treatment at all. Despite this, doctors, employers, and judges regularly refer addicted people to treatment programs and rehab facilities based on the 12-step model.   In The Sober Truth, acclaimed addiction specialist Dr. Lance Dodes exposes the deeply flawed science that the 12-step industry has used to support its programs. Dr. Dodes analyzes dozens of studies to reveal a startling pattern of errors, misjudgments, and biases. He also pores over the research to highlight the best peer-reviewed studies available and discovers that they reach a grim consensus on the program’s overall success.   But The Sober Truth is more than a book about addiction. It is also a book about science and how and why AA and rehab became so popular, despite the discouraging data. Dr. Dodes explores the entire story of AA’s rise, from its origins in early fundamentalist religious and mystical beliefs to its present-day place of privilege in politics and media.   The Sober Truth includes true stories from Dr. Dodes’s thirty-five years of clinical practice, as well as firsthand accounts submitted by addicts through an open invitation on the Psychology Today website. These stories vividly reveal the experience of walking the steps and attending some of the nation’s most famous rehabilitation centers.   The Sober Truth builds a powerful response to the monopoly of the 12-step program and explodes the myth that these programs offer an acceptable or universal solution to the deeply personal problem of addiction. This book offers new and actionable information for addicts, their families, and medical providers, and lays out better ways to understand addiction for those seeking a more effective and compassionate approach to this treatable problem. 

30 review for The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry

  1. 5 out of 5

    Carmen

    "You're sick. And you'll always BE sick." - Darla, BtVS, Episode 1.7 This book is a case of very interesting subject matter, but boring execution. I'm going to break down this book for you so you don't have to read it. Let me explain the author's views to you: - AA programs blame, humiliate and shame addicts. - AA has too much emphasis on religion and a higher power. - AA promotes the incorrect and untrue statement that only addicts can treat other addicts. - AA says alcoholism is a disease; the a "You're sick. And you'll always BE sick." - Darla, BtVS, Episode 1.7 This book is a case of very interesting subject matter, but boring execution. I'm going to break down this book for you so you don't have to read it. Let me explain the author's views to you: - AA programs blame, humiliate and shame addicts. - AA has too much emphasis on religion and a higher power. - AA promotes the incorrect and untrue statement that only addicts can treat other addicts. - AA says alcoholism is a disease; the author states it is a behavior or set of behaviors. - AA says you can NEVER cure your alcoholism, you are an alcoholic for LIFE. Author says you can cure yourself from addiction, you do not have to be an alcoholic for life, you can get better. - AA can't deal with the fact that stopping drinking doesn't always make people's lives magically better. People who are still depressed and have shitty lives and/or kill themselves are NOT accepted by the AA community, they are shut down when they try to share their stories. - Some people in AA are bad people, predators who prey on the vulnerable, and/or people who enjoy shaming and humiliating other people. People are sometimes sexually and financially preyed on by predators they are exposed to at meetings. And AA's culture of encouraging the shaming and humiliation of others can be like a fun buffet for sadists. "..like the Catholic Church. Some parishes may be really, really great and strong and wonderful with a great priest. And others can be really, really corrupt with a pedophile [priest]. Who knows what you are going to get? That's the bad thing about therapists just telling people to go to AA. They have no idea what they're going to get." - AA treats only the symptom (drinking) not it's cause(s). - AA does not offer individual programs, instead it's a mass treatment that's supposed to work for everyone. This is a bad idea. - AA often shames and discourages people from using prescription anti-depressants or other psychiatric medicine because they see it as another "addiction." Members are often shamed and scolded for taking pills prescribed by a psychiatrist. - The author promotes psychotherapy in the place of AA. It's individual, it's compassionate, and it treats the cause of the problem not just the symptom. Of course, the author IS a psychiatrist. Okay, that sums up the book. My personal thoughts: - No one is going to get better unless they want to get better. You can go to AA, you can go to psychotherapy, but no one can force you to get better against your will. - AA does push religion, sometimes to a frightening extent. - AA does teach helplessness and eternal sickness. I can't say I think this is the best attitude. - I hate shaming and humiliating people, I can hardly believe that would be a good idea. - AA is a great social (and FREE) program that gives people friends and support. Much like church. However, I think if you are going to be someone who goes to AA, you should also get therapy. I understand not everyone can afford this and thus AA's appeal to a lot of people. - It's rather scary that AA is often seen as The Only Way to treat alcoholics. - AA works for some people, it doesn't for others - and it should be OKAY if you are creeped out by AA and its philosophies. There should be some other widely known option for treatment for people who don't want to be in AA. However, tons of people are "ordered" to go to AA, and this isn't always the best thing. Tl;dr - Is AA really the only choice for alcoholics' recovery? Does AA even work? AA is unregulated and ungoverned, and this can lead to some shitty AA groups run by some shitty people. This author stresses that psychotherapy is a much better option for people for a wide range of reasons. However, AA is free. What's the answer? Is there an answer? UPDATE 03/12/2020 https://nyti.ms/2IPqktL "Alcoholic Anonymous vs. Other Approaches: The Evidence Is Now In"

  2. 5 out of 5

    Leigh Sewell

    I became a heroin addict after witnessing my fiances murder. In and out of in patient and out patient rehabs as well as countless NA and AA programs, the 12 step program never worked for me. I congratulate those it did work for but being out spoken about it not working for me in this community, well, I may as well have shouted hail Satan in church. I'm really looking forward to reading this. Fingers crossed to win the giveaway. Oh PS I'll have five years clean in a couple months. :) I became a heroin addict after witnessing my fiances murder. In and out of in patient and out patient rehabs as well as countless NA and AA programs, the 12 step program never worked for me. I congratulate those it did work for but being out spoken about it not working for me in this community, well, I may as well have shouted hail Satan in church. I'm really looking forward to reading this. Fingers crossed to win the giveaway. Oh PS I'll have five years clean in a couple months. :)

  3. 5 out of 5

    Sarah

    As a therapist who frequently works with clients struggling with substance abuse, I’m baffled that I’ve never considered the fundamental question of whether the AA model is actually effective, and under what circumstances it may be contraindicated. How have I gone so long taking such care to provide individualized treatment in relation to mental health issues, but blindly relied on a cookie-cutter approach to substance abuse? One-size-fits-all thinking and treatment represents the direct opposit As a therapist who frequently works with clients struggling with substance abuse, I’m baffled that I’ve never considered the fundamental question of whether the AA model is actually effective, and under what circumstances it may be contraindicated. How have I gone so long taking such care to provide individualized treatment in relation to mental health issues, but blindly relied on a cookie-cutter approach to substance abuse? One-size-fits-all thinking and treatment represents the direct opposite of my values as a helping professional. So where does this seemingly incontestable reverence for the 12-steps come from? The outlandish claims of AA’s overwhelming success, as Dodes points out in this book, are based almost wholly on bad science and flat out unsubstantiated propaganda. In fact, from the data that is available (admittedly limited), AA has only a 5-10% success rate for those who join. This is particularly disconcerting as I contemplate my training as a therapist and the fact that, of all the mentors and teachers I’ve had (undoubtedly good, caring people), not one has questioned the validity of universal AA referrals. Moreover, lack of “success” in recovery (the definition of which being a whole other can of worms) is commonly perceived as “not being ready” or “not being committed” to addressing unhealthy behaviors. What an outrageous assumption! And a demeaning, unhelpful assumption at that! Making that judgement is comparable to claiming that someone who isn’t successfully losing weight via jogging is fundamentally “not ready” to adopt a healthier lifestyle. What about swimming? Dancing? Tennis? The idea that you’re somehow failing because you’ve not been presented with interventions that suit your own individual preferences and personality is absurd and destructive. While it’s true that there are limited alternatives at this point, and that our understanding of addiction is far from complete, in my mind that is no excuse for not exploring the full spectrum of a client’s options and thinking outside the box for interventions that offer more individually effective solutions. Of course the argument that AA is entirely ineffective for everyone is clearly false. That said, as a culture we’ve somehow become brainwashed into the belief that 12-step programs are the be-all end-all of substance abuse treatment. Considering that there’s no substantive evidence supporting this claim, and that the 12-step approach has been demonstrably harmful for some, the belief that AA is the one and only way is incredibly dangerous and clinically reckless. I wholeheartedly recommend this book for anyone who is actively engaged in treating, researching, or otherwise curious about substance abuse issues. It brings up insightful questions and concerns that should be obvious, but somehow aren’t, and encourages critical thinking about a problem that has plagued and puzzled people for centuries.

  4. 5 out of 5

    Kara

    The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry, co-authored by brothers Lance and Zachary Dodes, is a far less dry and more radically change-oriented book than its title might suggest. What makes this read so compelling and its ideas so unusual, IMHO, is the primacy of individual human beings who struggle with addiction issues -- their personal thoughts, feelings, experiences -- in its assessment of the value of treatment options for those . Because of The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry, co-authored by brothers Lance and Zachary Dodes, is a far less dry and more radically change-oriented book than its title might suggest. What makes this read so compelling and its ideas so unusual, IMHO, is the primacy of individual human beings who struggle with addiction issues -- their personal thoughts, feelings, experiences -- in its assessment of the value of treatment options for those . Because of this fresh, humanistic perspective I believe the book is likely to be of great value to both readers drawn to this topic for reasons of personal experience (broadly speaking -- I’m not just talking about the addicts themselves) and/or those interested in the problem more generally because of its impact on society as a whole and the grievous damage it does to so many human lives and human relationships. In my view, The Sober Truth successfully discredits the popular assumption that 12-step programs such as Alcoholics Anonymous (AA), its various affiliates focused on other types of addiction, and the great many other rehabilitation programs that incorporate significant components of the 12-step method into their own methodology not only are unnecessary for successful recovery, but that these programs can set individuals back in their attempts to curtail their substance abuse (or other targeted behavior) and sustainably change their lives. You may imagine, as I did, that the book’s attack on the legitimacy of the 12-step treatment modality created by AA would rely on the deployment of in-depth analysis of a variety of scientific research studies on these programs’ (as well as other forms of treatments’) ability to provide their respective participants with successful coping methods and effect sustainable life change. While some observational studies (necessarily of less value than randomized treatment trial studies) are reviewed in the book, science is not the weapon the book uses in its argument. First of all, there is a dearth of reliable research available on the efficacy of 12-step and other addiction treatments, either individually or comparatively. Summing up the reasons for the lack of “good science” available on this topic, the authors state: “A poor understanding of these issues--the need for randomization, the difference between correlation and causation, and the power of the compliance effect--has colored much of the research that has been conducted to date about the effectiveness of 12-step membership and attendance” (p. 33). Existing research is surveyed in greater detail with applicable limitations set forth straightforwardly and specifically in the book’s chapter: “Does AA work?” However, the authors make clear their belief that numerical data would not be the most effective fodder for an attack on ineffective treatment modalities. In Chapter Nine, “The Failure of Addiction Research and Designing the Perfect Study,” they explain the foundation of their approach: “These days, virtually every addiction journal assigns far more value to statistical studies than to clinical findings. The primary claim is that words are not rigorous; number are. Yet this perspective fails to account for the complexity of human beings, who are, let’s face it complex than any number could possibly assimilate” (p. 157). Accordingly, most of the argument involves straightforward discussion of the particular history and practice of the 12-step programs, which highlights their origins in ideology rather than science and experience , and more critically, their rigidity and dogmatism. The 12-step programs hold themselves out as the only likely effective -- approach to addiction problems of manifold particularities experiences by a diverse cross-section of people in our society. This book is at its best when it points out the poor reasoning behind some of AA’s cherished dogma and the very real threat some of its bad ideas pose to participants’ chances of recovery. If you only read one chapter of this book, make it “The Myths of AA” in which the authors quickly and powerfully expose the contradictions between people’s experiences of addiction and the one-size-fits-all narrative of addiction and recovery that underlies the 12-step system. All this said, The Sober Truth as Dr. and Mr. Dodes tell it is not hopeless. While AA’s 12-step model is knocked down, psychotherapy is held up as an alternative that can meet people’s individual needs with a depth of empathy and flexibility of response unavailable in the former modality. What is powerfully persuasive about this and all the ideas propounded in the book is the openness to change and an implicit expectation of dialogue among treatment participants (before, during, after), clinicians, loved ones and other people with relevant experience in a continuing public discourse about how best to fight the problem of addiction and ameliorate affected lives. This openness is communicated in various ways throughout the book. Most explicitly, a long chapter includes extended narrative accounts by people with 12-step program experience. Some positive views are expressed; most assessments are mixed or largely negative. The relative range of viewpoints presented, and especially the lack of heavy editing of these narratives, demonstrated to me the value of the personal particulars of these stories to the authors. They didn’t cherry pick for useful quotations, or ones that clearly and succinctly set forth particular views, or ones particularly expressive of the full spectrum of positive and negative experiences with 12-step treatment. I got the sense that the authors took these contributors’ ideas as they found them, more or less, and that spoke volumes to me. I think this book is really worthwhile reading. Please be advised I received a free copy of this book from the LibraryThing Early Reviewer program in return for a promise to publish an honest review. Thank you for reading my ideas; I hope they prove helpful to some of you.

  5. 5 out of 5

    Chris

    This is a curious book. I picked it up for a book club that I'm going to soon, but I wanted to get some thoughts down while it's still fresh in my mind. A little backstory, I have a history of substance abuse primarily with alcohol, and have been to a few AA meetings myself. I've been sober for almost three years now. I went to AA as part of a rehab program that was mildly 12 step based, but really was just group and education based. Rehab really helped me, but the actual AA meetings themselves This is a curious book. I picked it up for a book club that I'm going to soon, but I wanted to get some thoughts down while it's still fresh in my mind. A little backstory, I have a history of substance abuse primarily with alcohol, and have been to a few AA meetings myself. I've been sober for almost three years now. I went to AA as part of a rehab program that was mildly 12 step based, but really was just group and education based. Rehab really helped me, but the actual AA meetings themselves really put me off for reasons that the authors get into in detail. What most people don't know is that there is no evidence that AA actually does any good for most people. AA took off and became what it is today for the most American of reasons, good marketing. As the authors of the book go through in detail, AA for most people doesn't work. In detailed studies with control groups it often does worse than doing nothing at all. Both the spontaneous cure rate (doing nothing) and AA have a success rate of about 5-10%. Why does AA have a such a terrible record? There a bunch of theories that the authors get into. The reason most people are put off by AA is the overtly religious and "moral" aspects of the program. AA is a deeply religious organization, and is run pretty much as a religion. It maintains a disease based theory of addiction even while just about all the experts now dismiss this as wrong. It maintains if AA doesn't work for you it's your fault, not AA's fault. As the authors note, if you were taking a cure for cancer and it didn't work, would you blame yourself or the cure? So why 4 stars instead of 5? Because the authors themselves have some rather strange biases that creep into the narrative. They spend the entire book railing against AA for not using evidence based medicine, then at the end they have a strange rant against evidence based medicine. This is mainly just a medical turf war, the authors prefer psychological based treatments rather than pharmaceutical ones. It's mainly turf war stuff. That being said, if you've ever been to a 12 step meeting or know someone who has our think should be going to one, pick this up. It's a great overview of the huge flaws in the methodology of those systems while at the same time pointing out the good that they can do.

  6. 4 out of 5

    Stefano

    Not a bad book per se, but there is some misleading and deceptive bias in this book if you look at the cover! The book addresses mainly the scientific-medical ratio of success of AA program put in relationship with the legal court-orders to follow a 12-steps program and its reliability from a scientific-medical point of view. Fair enough! This is what part of the title states. THEN, the book starts to address the rehab industry which is based on the 12-steps program (with the brouhaha of money, Not a bad book per se, but there is some misleading and deceptive bias in this book if you look at the cover! The book addresses mainly the scientific-medical ratio of success of AA program put in relationship with the legal court-orders to follow a 12-steps program and its reliability from a scientific-medical point of view. Fair enough! This is what part of the title states. THEN, the book starts to address the rehab industry which is based on the 12-steps program (with the brouhaha of money, frauds, non professionalism ...) ... more than fair, but this point is against the “industry”. So why transform it in an attack to 12-steps programs? It is like to criticize the industry related to pseudo-therapists, psychologists, psychiatrists ... to demolish Psychology as such??? THEN it starts to address the problems of therapy related to addictions and SURPRISE ... the 12-steps program works for a range of addicts (and surprise ...) LIKE EVERY OTHER APPROACH!!! So the book says at the end that the major skill is to identify the better approach for every individual, and the 12- steps programs can really help some patterns ... like every other method or approach. Now ... you see why the Cover of the book is so misleading?

  7. 5 out of 5

    Scott Helms

    AA works...about 5% of the time. rehab isn't much better and is EXPENSIVE! this is tragic. we need real medical AND psychological solutions to help with substance abuse problems in our world. AA works...about 5% of the time. rehab isn't much better and is EXPENSIVE! this is tragic. we need real medical AND psychological solutions to help with substance abuse problems in our world.

  8. 5 out of 5

    Joseph M. O'Connor

    Eye-opening. I'm in AA. I've been sober for over 13 years. Throughout that time I have made my own interpretation of what The 12 Steps actually mean, and how to work them. My "renegade" attitude fits very closely with what Dr. Dodes is talking about in his more meaningful chapters. Take note! Dr. Dodes has meaningful chapters in his book and chapters in which he just seems to vent his anger at the AA process. That really isn't productive; indeed, his invective nearly prevented me from reading furt Eye-opening. I'm in AA. I've been sober for over 13 years. Throughout that time I have made my own interpretation of what The 12 Steps actually mean, and how to work them. My "renegade" attitude fits very closely with what Dr. Dodes is talking about in his more meaningful chapters. Take note! Dr. Dodes has meaningful chapters in his book and chapters in which he just seems to vent his anger at the AA process. That really isn't productive; indeed, his invective nearly prevented me from reading further and getting to the meat of his argument. But I forgive him his rant. He's right in many respects. The most important things being that AA will NOT result in a cure; AA will NEVER "get anyone sober;" going to AA meetings will NOT help anyone stop drinking. UNLESS THEY REALLY WANT TO STOP! And I dare say the same is true for any other drug/drink/gambling/over-eating/over-working/sex-addicted behaviour out there. Sigmund Freud himself ain't gonna help someone who doesn't want to change. That single factor - effecting a change in one's behaviour - is, in the final analysis exactly what Dr. Dodes prescribes as the solution to alcoholism. Find, through analysis, what the problem is, look at the behaviour it causes, and effect a change in that behaviour. In his "MD-speak" this becomes "determine what helpless feeling leads to the displacement behaviour, deal with the feeling, and find that you are able to stop drinking/doing drugs/gambling/over-enthusiastic sexual behaviour, etc., etc." Note that Dr. Dodes does not seem to know anyone for whom AA, with all its warts and foibles, was a positive influence and led to a happier healthier life. I guess that am here to say that for some people like me, AA has helped to work wonders. It's true that I was really done with drinking. It's true that I wanted, desperately, to stop. But... aren't people like me exactly those for whom AA was created? The AA that works for me encourages its members to seek psychiatric care. I do. It encourages its members to obtain medical treatment for depression. I do. It encourages its members to think about and study and try ANY alternative treatment; and to use that treatment if it helps. I do. And my AA - the San Francisco Fellowship - does not put down alternative treatments. It suggests them. I do, too. And if any AA hardliner reads this review and sees my name and chooses to chastise me for "breaking anonymity," well... the Big Book was written between 1935 and 1939. Almost 80 years ago. Things change. Society evolves. Get over it.

  9. 5 out of 5

    Lauren Mcarthur

    So, I thought this was an interesting book. I agree kind of with it, though I never have had to face a drug/alcohol problem I know many who did. I don't want to discount the 12 step process completely because I know it is a long hard process to become sober, and it has worked for some people I know. However, I was shocked to see some statistics in the book. Now, I don't know if they are all reliable because this book is written subjectively against the 12 step program, and I'm sure if AA were to So, I thought this was an interesting book. I agree kind of with it, though I never have had to face a drug/alcohol problem I know many who did. I don't want to discount the 12 step process completely because I know it is a long hard process to become sober, and it has worked for some people I know. However, I was shocked to see some statistics in the book. Now, I don't know if they are all reliable because this book is written subjectively against the 12 step program, and I'm sure if AA were to release statistics it would be somewhere in the middle. Over all however I came out of this book with a new perspective on AA. I believe in therapy and that can help many people, but that is not a one way path, and it is tailored to the client. The 12 step process is just that, steps. Not tailored to individual needs, and obviously not everyone fallows recovery in the same way. So why 3 stars? While I liked the book, it was not really attention grabbing at some parts. This could have been because the topic does not pertain to me, and I couldn't directly relate. I do want to be a therapist, so it did peek my interest in substance abuse. I would recommend this book for professionals in the field, people who like direct facts or are extremely interested in this topic, and people who thought AA didn't work for them. If AA worked for you, I wouldn't read this book. It was a (mostly) quick read, which I liked because I have read a lot of these type books, and some of them get very tedious, repetitive, and repeat themselves too much. I was glad I won the giveaway, so I greatly thank the author for sending me the book. I would just like to say to those who have an addiction, I bet it is scary, and daunting to give recovery a chance.I'm guessing a lot of people reading this book, have been through AA and relapsed, and there are many other way's to get better. But I promise you it can change, so please keep trying and don't give up.

  10. 5 out of 5

    Kathleen

    "The program works if you work it," is one of the least rigorous statements ever made. Any evidence of the efficacy of twelve step programs is entirely anecdotal, and proponents of the programs openly admit that there is a high recidivism rate. Yet there have been very few studies about the long term efficacy of twelve step programs and those that have been done suggest that rehabilitation isn't nearly as successful as the common lore would have it. I could have done without the testimonial chap "The program works if you work it," is one of the least rigorous statements ever made. Any evidence of the efficacy of twelve step programs is entirely anecdotal, and proponents of the programs openly admit that there is a high recidivism rate. Yet there have been very few studies about the long term efficacy of twelve step programs and those that have been done suggest that rehabilitation isn't nearly as successful as the common lore would have it. I could have done without the testimonial chapter in a book that is all about looking at the problem of addiction in a deeper, more scientific way. As heartbreaking as the family that misread the signs of an imminent suicide as making amends, I don't think an emotional appeal is necessary to make the point. Real medical and psychiatric treatment by professionals would be superior to encouraging laypeople to take control of care. Overall, I found this argument persuasive, though there is a lot to be said for AA as a freely accessible service available anywhere in the country. As expensive as rehab might be and as unpalatable as the religious aspect of twelve step programs might feel, the cost of better treatment might make AA the only option for a lot of people. This book is definitely worth a read, as the subject is one that deserves serious consideration.

  11. 5 out of 5

    Holly Whitaker

    good, but ultimately biased towards psychotherapy I thought this book was ripe with relative and valuable points why as doesn't work. But completely biased towards the authors own profession and yet just one more account I "do it my way". good, but ultimately biased towards psychotherapy I thought this book was ripe with relative and valuable points why as doesn't work. But completely biased towards the authors own profession and yet just one more account I "do it my way".

  12. 5 out of 5

    AJ

    A detailed look into the shortcomings of Alcoholics Anonymous, The Sober Truth refutes many claims of AA's efficacy (citing many studies that have been done over the years) and contemplates what it would take to scientifically find and validate a truly effective addiction treatment paradigm. This book is written in the same vein as Inside Rehab: The Surprising Truth About Addiction Treatment—and How to Get Help That Works and Clean: Overcoming Addiction and Ending America's Greatest Tragedy, so A detailed look into the shortcomings of Alcoholics Anonymous, The Sober Truth refutes many claims of AA's efficacy (citing many studies that have been done over the years) and contemplates what it would take to scientifically find and validate a truly effective addiction treatment paradigm. This book is written in the same vein as Inside Rehab: The Surprising Truth About Addiction Treatment—and How to Get Help That Works and Clean: Overcoming Addiction and Ending America's Greatest Tragedy, so I would recommend reading all three if you're interested in the topic of effective addiction treatment.

  13. 4 out of 5

    Michelle

    I received this book through the good reads first read program. I enjoyed this book. It was scientific without being too scientific and could be read by someone with no psychological knowledge as well as someone with an extensive degree. I fully support the idea that the 12 step idea is significantly flawed and unreliable.

  14. 5 out of 5

    Zoe

    Important book. People need to be more aware of the failings of the 12 step model in order to start funding research into alternative methods to beat addiction.

  15. 5 out of 5

    Lynn Kearney

    It certainly debunks 12-step programs but I'm not completely convinced by the alternatives suggested for addiction treatment. It certainly debunks 12-step programs but I'm not completely convinced by the alternatives suggested for addiction treatment.

  16. 4 out of 5

    MonumentToDecency

    Before I existed, my grandmother had a good friend who was an alcoholic. My grandmother accompanied the friend to to a couple of AA meetings. At one of the meetings my grandmother picked up a fridge magnet featuring the AA version of the serenity prayer: God grant me the serenity to accept the things I cannot change Courage to change the things I can and the Wisdom to know the difference As I kid I would read that prayer and think how nice it sounded. To be able to just deal with not being able to d Before I existed, my grandmother had a good friend who was an alcoholic. My grandmother accompanied the friend to to a couple of AA meetings. At one of the meetings my grandmother picked up a fridge magnet featuring the AA version of the serenity prayer: God grant me the serenity to accept the things I cannot change Courage to change the things I can and the Wisdom to know the difference As I kid I would read that prayer and think how nice it sounded. To be able to just deal with not being able to deal with stuff - so simple. I got my hands on the NA book (5th Ed.) when I was maybe 15. It was full of stories about people using drugs and/or alcohol, and their path to abstinence through the 12 Steps, and a lot of talk about god and higher powers. As an adult, I've watched so many friends and acquaintances struggle through their addictions, many dying in the process, addiction has featured in my family, and at one point in time nearly everyone I knew had some kind of link to addiction. I know what it is, how it behaves, how it saves, and how it ruins. As an adult, I am firmly opposed to the incredibly simplistic, idealistic, guilt-laden, bible bashing of the 12 Step program. I have a large collection of ancient books on diagnosis and treatment of 'deviance' and addiction, comprised of theories and ideas spanning the last century. The so-called science behind the whole of AA fits firmly in there right next to Dr. Kellogg and his enemas for aneurysms - i.e. it is bogus and causes more harm than good. The 12 Step program is based on stripping away a persons identity, leaving them as nothing but 'addict,' in mind, body and name. It tells people they will forever be their addiction, that there is no true recovery, only a lifelong battle against the weakness of your 'disease' which you willfully give in to (addiction is not a disease, it is a behaviour). Each time someone relapses, the NA/AA program strips away all their hard work, shaming and shunning anyone for simply becoming overwhelmed on their journey. AA ignores that relapses can increase a persons knowledge of their addiction, can help to reaffirm willpower, and help with subsequent attempts to get clean. The Sober Truth is a brilliant, full scale examination of what precisely is wrong with the AA approach. Lance Dodes M.D. is a psychiatrist and psychoanalyst, an associate clinical professor of psychiatry at Harvard Med School. He has a very impressive resume and his career spans 30 odd years. If anyone is going to write a book on this stuff, it had to be him. The book collects research results and methodology to show why AA doesn't work, why it won't and can't work, and how the major US rehab centres use the lure of prestige to up-sell the AA program even though they know it doesn't work. The irony is, even using research conducted by AA and the rehabs, the success rate of the 12 Step program is fucking embarrassing. The Sober Truth is presented in a very easy to read format, and while it covers a lot of research and stats you by no means need to be anything like a scientist to read and understand it. A ten year old could consume this with no problems. The Sober Truth importantly also offers solutions based in science with proven, replicable results - what does work and why it works. And the best bit: alternatives to AA programs are a heckload easier than the 12 Steps. Success: Why does the 12 Step program seem like a resounding success, all we ever hear about it is good news. Even the justice system refers people into the program, so it can't be all that bad, right? Wrong. The success rate is somewhere around 5% but it seems much higher "because most of us hear only from the people who succeeded in the program, it is natural to conclude that they represent the whole". Failure: The AA approach is that they give you the tools and you 'work the steps'. According to AA, if you fail, it wasn't the program, it was you. "Imagine if similar claims were made in defense of an ineffective antibiotic". We gave you the treatment, we know it works, so if it failed, it must be that you're just a failure. "In professional medicine, if a treatment doesn’t work, it’s the treatment that must be scrutinized, not the patient. Not so for Alcoholics Anonymous." Religion: When you've had a particularly hard time and you relapse or things are just really really shit and you feel like you are falling apart, it's nice and reassuring to have someone there to comfort you. And AA, like church, does lend a sense of community to people who need that. But a sense of community is not a treatment for addiction. At the end of the day you still have to live with yourself, trapped inside your mind with the knowledge that drives you to self-medicate. All the comfort and community in the universe can't change what's happening inside us. According to AA, sitting in a circle, pretending to be positive ('fake it til you make it'), hanging out with other people also struggling like fuck to not use today (mentors), not talking about anything that actually matters (they forbid talking about negative emotional issues), will help fix you. They believe that depression is caused by a lack of faith. They believe taking any prescribed medication to help with anxiety, depression, etc is toxic. You have to completely strip away the last vestiges of power you have within and instead give yourself up to a 'higher power' because you literally cannot be trusted to be an adult. If you felt weak before, prepare to feel completely useless because according to AA: you are, you just haven't realised it yet. That one thing, giving yourself up to a higher power because you are weak and useless, goes against absolutely everything we know about treating addiction. To treat addiction we build people up, show them they are functional. We give people back their power. I'm just going to do some quotes with headings now because if I comment on all the quotes I have in my notes we'll be here for longer than it takes to succeed at AA. (1 hour later... And of course I wrote a whole bunch more stuff because I just can't not. But it's interesting, so read away. It won't kill you.) Morality: "The notion that people with addictions suffer from a failure of morality to be indexed and removed is fundamental to Alcoholics Anonymous. Yet addiction is not a moral defect, and to suggest that does a great disservice to people suffering with this disorder..." Degradation: The degradation woven through these steps also seems unwittingly designed to exacerbate, rather than relieve, the humiliating feelings so common in addiction. If moral self-flagellation could cure addiction, we could be sure there would be precious few addicts. On Step 5: admitting to god, yourself and others, the wrongs you have committed: "People suffering with addictions as a rule tend to be well aware of the many “wrongs” they have committed. Awareness of this fact doesn’t help the problem". Indeed, awareness of wrongs committed during addiction are often a trigger for addictive behaviours. No wonder 95% of people don't get through the program. Rehabs: "[I]n rehab, one feels that one is doing something, taking on a life-changing intervention whose exorbitant expense ironically reinforces the impression that epochal changes must be just around the corner." Then you have to go home, to the house where you used, to the people that use with you or that were a trigger for using, to a job or no job which drives your using, to a town where every place you look reminds you of using. And suddenly you wish you were back at rehab patting that nice horse, but you're not, you're here in hell. Repeating Rehab: "What’s especially shocking is how the rehab industry responds to these individuals: they simply repeat their failed treatments, sometimes dozens of times. Repeat stays in rehab are very common, and readmission is almost always granted without any special consideration or review. On second and subsequent stays, the same program is offered, including lectures previously attended". What's that thing about the definition of insanity? Yeah, you know the one. Bill Wilson, the guy who thought up this AA nonsense was an addict, an alcoholic to be precise. He invented the steps to treat himself. And he was successful, kind of. He didn't end up treating the cause of his addiction, just the addiction. So when he was free of alcohol he switched to a slew of other addictions: "Bill was compulsive, given to emotional extremes. . . . Even after he stopped drinking, he was still a heavy consumer of cigarettes and coffee. He had a sweet tooth, a large appetite for sex, and a major enthusiasm for LSD and, later, for niacin, a B-complex vitamin.” In the end, Bill, basically a chain smoker, died of emphysema. One of the biggest issues with AA is that they base their success rate on how many people remain in the program. They don't count people who leave. People who leave (for whatever reasons) are considered failures, 'they didn't do the steps properly,' therefore the program didn't fail, the person did. When I started uni, there were around 1000 people in my psych degree. By graduation around 150 were left. Proper figures would show 15% of students graduated (that's those 150 students). But AA would say that 100% graduated because they do not count people who leave. Saying 100% succeeded makes it look like 100% followed the program to completion, but they didn't. In the case of AA 95% don't follow to completion. Most cease attendance before 3 months. "AA claims; namely, that the program “works if you work it.” Which is another way of saying that people who do well, do well. What does this mean about whether AA itself “works”?" "Harvard biostatistics professor Richard Gelber said, “The main problem is the self-fulfilling prophesy: the longer people stick with AA the better they are, hence AA must be working. It is like saying the longer you live, the older you will be when you die.”" See how that doesn't work, it's not even remotely logical. Are you better because you stuck with AA or did you stick with AA because you were better? There's a valid point there that people who stick with AA are already more inclined toward recovery (and god). Research shows that people who are more involved in their healthcare attend healthcare appointments (doctors/specialists/gym membership/etc) more regularly. Are they healthy because they go to the doctor or do they go to the doctor because they're healthy? Hint: they go to the doctor because they're healthy. People who go to AA likely do so because they're already that way inclined. Those AA attendees very likely fit into the fucking big cohort that undergo spontaneous recovery regardless of treatment. Bombshell: "A higher percentage of alcoholics get better without any treatment than with AA, suggesting that some of AA’s success rate may simply be nature taking its course." That 'higher percentage' is around 35% of alcoholics. As opposed to AAs still questionable 5% success rate. Furthermore, research shows that people who join AA and then leave due to relapse/guilt/struggle tend to have much, much worse outcomes that people who never join at all. I can't rate this book highly enough. Dodes explores AA and addiction in depth, he remains objective throughout and always backs his statements and claims with valid methodologically sound research. Yet, what I value even more highly than the AA take down is the 'So What Does Work to Treat Addiction' chapter. Lots of therapists and specialists understand addiction from a chemical point of view. Addiction happens because not because of drugs or alcohol but because of what is going on in the mind. Dodes really fucking gets it. If you want to read a really, really good book about treating what drives addiction, about how to predict when you're going to next use, about how to see psychological triggers you didn't even know existed, then pick up a copy of Breaking Addiction: A 7-Step Handbook for Ending Any Addiction My Rating: 10 illogical bible bashers out of 5

  17. 5 out of 5

    Maggie

    The premise is great. Why is AA the go-to recommendation for addicts? Although it sifts through data and explains research methods ad nauseum, it puts forth a great argument that there's no scientific reason that AA should be the only treatment method for addiction. I wish they would have spent more time going into detail about their recommended alternative. But, it's a great read that's quite thought-provoking. The premise is great. Why is AA the go-to recommendation for addicts? Although it sifts through data and explains research methods ad nauseum, it puts forth a great argument that there's no scientific reason that AA should be the only treatment method for addiction. I wish they would have spent more time going into detail about their recommended alternative. But, it's a great read that's quite thought-provoking.

  18. 4 out of 5

    isla

    I can see the flaw in this book already through the title. AA is not a program based on science. "Bad" or otherwise. It is a spiritual program and who is to say that any spiritual program is "bad" or good? I can see the flaw in this book already through the title. AA is not a program based on science. "Bad" or otherwise. It is a spiritual program and who is to say that any spiritual program is "bad" or good?

  19. 5 out of 5

    Robb Bridson

    What I enjoy most about this book is the way it is a microcosm of the problems we see in science in general and in society as general. There are problems showing up in the bias of peer-reviewed journals, in the bias of what sorts of studies attract funding, in the way funding and bias shape studies and interpretation of results, in the way culture shapes popular views of science, and how these cultural biases create "facts" from thin air. I used to work in a local government substance abuse agenc What I enjoy most about this book is the way it is a microcosm of the problems we see in science in general and in society as general. There are problems showing up in the bias of peer-reviewed journals, in the bias of what sorts of studies attract funding, in the way funding and bias shape studies and interpretation of results, in the way culture shapes popular views of science, and how these cultural biases create "facts" from thin air. I used to work in a local government substance abuse agency, and I was responsible for the outcome evaluation study. Yes, one part-time worker with the title "student" was running the study. That is the amount of resources put into the research. But what did it matter? The main purpose they had for the study was in finding good news to share with the public and politicians. One such bit of "good news" I found, to the extent anything could be found (very low response rates, sample too small to be statistically valid-- a lot of similar problem are mentioned on this book) was that it appeared AA/NA attendance improved one's chances of avoiding relapse. Even then I was a bot skeptical, and in some interviews I was starting to catch a broader possibility not captured in the database that any support group had this effect. Alas, qualitative data, crucial to social science and yet hard to capture and undervalued, was not accounted for in the study. But, again, what did it matter? I came to realize that AA/NA attendance was considered an outcome in itself, not a simple variable, so confident was the discipline in its efficacy. This book does a good job of relaying the hardships of such research, and I think it can also explain better, with examples, to the laymen of the public (as well as those scientifically minded folk who expect society and psyche to be fully discovered on stats and lab experiments), than any textbook. As far as the subject matter goes, the book successfully, I think, tears down the myths and the bad science of the 12-step programs... but it leaves some doubt as to whether the author's preferred method will work. Since no valid research exists to test it, the author only gives suggestions on how to test it... but then with all the biases against it, it seems unlikely. Also, while the book's commentary on reductive "hard science" attempts to understand psychology are apt, I think the book might be a bit too dismissive of their tactics. While I do not think genetic or chemical remedies will ever be a magic cure for addiction-- I agree with the theory of addiction the author espouses-- I think it possible such research may provide some useful understanding and even some partial treatments. And the one other problem I had was the chapter with all the addict testimonials. I don't think they were methodically collected or organized well enough to provide case study value, and for the most part they were just a few opinions thrown in, and I think the book could have benefited more from deeper analysis than original sources in this case. But overall a great book for those interested in addiction or just the social sciences.

  20. 5 out of 5

    Alex DiFrancesco

    I should mention that I received this book as part of a Goodreads give-away. I should also mention that part of the reason I was interested in this book is because I went through a 12-step program when I was younger, and largely credit it with helping me become a better human being and even being one of the things from that stage of my life that saved my life. However, I've grown away from 12-step programs, and was interested to read more about why other people have, too, and why they do not serv I should mention that I received this book as part of a Goodreads give-away. I should also mention that part of the reason I was interested in this book is because I went through a 12-step program when I was younger, and largely credit it with helping me become a better human being and even being one of the things from that stage of my life that saved my life. However, I've grown away from 12-step programs, and was interested to read more about why other people have, too, and why they do not serve everyone they set out to. This book promised to speak to just that, and did. The book very clearly breaks down why 12-step programs don't always work for everyone, and in fact, only work for a small amount of people who seem predestined to succeed in them. The book talks about why that is, and about the mechanisms that AA has in place that shame people for failing rather than accepting its own failings as a program. Testimonials from former AA members illuminate both the pros and the cons of the program. One of the authors is a psychologist, and clearly favors the therapy approach to the AA approach. I think this approach certainly has its advantages. However, considering the author's criticism of the 12-step approach as too "one fits all," I think it's also true that therapy is not the answer for everyone, and a group setting such as AA helps people feel less isolation and more a part-of than therapy can. There is also a section where the author compares a rehab center to a "good psychiatric center" and finds the individual attention one gets in the latter more appropriate for aiding in addiction recovery---which is really a utopian view of psychiatric centers and a narrow view of rehab. All that said, I did find this book intriguing, and it was really great to read so many of the problems with AA reiterated by both the author and alumni of the program. I think this book should be read by anyone considering the best approach to treating their addiction.

  21. 4 out of 5

    Kelly McCubbin

    Coming from the point of view of an A.A. member, I find it hard to argue with Dodes assessment of the effectiveness of A.A.. He's right, it's got about a 5% success rate. And the studies that try to enhance and elevate that rate are hopelessly flawed. He also points out, very fairly, that folks who are driven to stick with it and stay in the program for a long time, have a much better success rate than those who are lacksidasical about it. He also, very fairly, implies that A.A. is often used by Coming from the point of view of an A.A. member, I find it hard to argue with Dodes assessment of the effectiveness of A.A.. He's right, it's got about a 5% success rate. And the studies that try to enhance and elevate that rate are hopelessly flawed. He also points out, very fairly, that folks who are driven to stick with it and stay in the program for a long time, have a much better success rate than those who are lacksidasical about it. He also, very fairly, implies that A.A. is often used by the Courts as well as medical professionals as a one size fits all solution to not have to really deal with adddiction in a larger sense and that we might be better off doing some actual good research. Can't argue it. That all said, if you can't stop and your life is falling apart and you are, perhaps, getting very ill, do what the doctor says, get some help. Go see a therapist. Go to A.A.. Find an alternative program. One of the arguments of this book is the very sound idea that we should encourage alternative addiction therapy. A.A. really does work for some people and makes them happy. Other things might work for you instead. Do everything you can think of until something, or several things, fit, because none of us want to see you die. In the meantime, let's do more research. And let's lean on one of the really glorious arguments of this book. "When networked pieces of anything come together, be they ants in a colony or neurons in a brain, the network exhibits emergent behaviors that are far more strange and complex than anyone could predict from looking at their consituent parts." In other words, use your tools, your 12 steps or your therapy or your meditation or whatever helps, but recognize that we are far more complex and deeply fascinating than what those tools can describe. Isn't that neat?

  22. 4 out of 5

    Tegan

    I checked out this book because I have an unpleasant history with twelve-step treatment programs, and wanted to prove to my family and care providers that there are other, better ways. For that purpose, it did not disappoint. The Sober Truth does exactly what it says on the tin: debunks the unscientific claims to success of AA/NA, rehab, and myriad other twelve-step-based programs. In fact, it goes a step farther in taking a wrecking ball to AA's cherished disease model, in which addicts are see I checked out this book because I have an unpleasant history with twelve-step treatment programs, and wanted to prove to my family and care providers that there are other, better ways. For that purpose, it did not disappoint. The Sober Truth does exactly what it says on the tin: debunks the unscientific claims to success of AA/NA, rehab, and myriad other twelve-step-based programs. In fact, it goes a step farther in taking a wrecking ball to AA's cherished disease model, in which addicts are seen as incurable victims of physiological dependence. To me, the cherry on top was Chapter 5, about what does work to treat addiction. There, Dodes sets forth a scientifically based non-disease model of addiction as a behavioral compulsion best treated through. All in all, the writing is clear, though somewhat lacking in style. I give the book four stars because about halfway through it began to feel a bit tedious, as though he was reiterating the same basic ideas in numerous ways. Perhaps this was simply unnecessary to me since I was already inclined to agree with him, or perhaps he needed to pad the text to book length, but I felt that either a little more concision, or enough style to keep my interest piqued, would have gone a long way. I hope this doesn't discourage others from reading the book-- twelve-stepping is a big part of our culture and doesn't deserve it's angelic reputation, so it really is worth reading, even if you have to force yourself to keep going at times.

  23. 5 out of 5

    David Ward

    The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry by Lance Dodes (Beacon Press 2014) (616.8606). Premise: Alcoholics Anonymous (AA), a twelve-step program for alcoholics, is only effective in overcoming addiction about 5% or 10% of the time. That's the claim on this book's dust jacket. And that's not good enough, says the author, who is a physician. Even more pointless than the AA program are “rehab centers,” which combine the Alcoholics Anonymous princi The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry by Lance Dodes (Beacon Press 2014) (616.8606). Premise: Alcoholics Anonymous (AA), a twelve-step program for alcoholics, is only effective in overcoming addiction about 5% or 10% of the time. That's the claim on this book's dust jacket. And that's not good enough, says the author, who is a physician. Even more pointless than the AA program are “rehab centers,” which combine the Alcoholics Anonymous principles with in-house medical care. These are no more effective, and a typical twenty-eight day stay costs $30,000, says the author, but the alternative seems to be madness and death. So what's the solution? The author fails to identify one. It sure sounds like the AA model is the best on offer. At least the one alcoholic in ten or one in twenty acknowledged by the author as having been helped by AA is better off, and attendance at AA meetings costs nothing! Maybe all AA provides is positive peer pressure, but it's better than nothing. Right? My rating: 7/10, finished 5/26/16.

  24. 4 out of 5

    victor harris

    As the title indicates, it takes the 12-step programs based on AA to task for spreading myths about the effectiveness of that approach for treating addiction. As he correctly argues, AA is nothing more than conservative religion cloaked in different jargon and it's founding was based on Christian beliefs. It also addresses the harmful "disease" mantra concerning alcohol addiction when there is no clinical support for such contentions. The rehab industry became lucrative selling such a propositio As the title indicates, it takes the 12-step programs based on AA to task for spreading myths about the effectiveness of that approach for treating addiction. As he correctly argues, AA is nothing more than conservative religion cloaked in different jargon and it's founding was based on Christian beliefs. It also addresses the harmful "disease" mantra concerning alcohol addiction when there is no clinical support for such contentions. The rehab industry became lucrative selling such a proposition and most using the 12-step model often do more harm than good. Unless of course, one goes to the " celebrity" rehabs where riding on yacht is supposedly a good cure for addiction. While worth reading for anyone suspicious of the claims of AA or turned off by their zealous religiosity. Which by the way, the best studies done, show a success rate for 12-step treatments as between 4-8 %, though they deceptively make outrageous claims boasting of much higher success rates.

  25. 4 out of 5

    Kristine

    The Sober Truth by Zachary and Lance Dodes is a free Goodreads advance reader copy of a hardcover book that I read in one evening in early May. Cinco de Mayo, in fact - a traditional, Corona-sponsored drinking holiday. Funny how that works. I had requested to receive The Sober Truth totally on a whim and, in reading it, I realize that I have a lot of positive bias toward theraputic environments and coping strategies that the Dodes don't necessary share. I see the benefit of familial support, the The Sober Truth by Zachary and Lance Dodes is a free Goodreads advance reader copy of a hardcover book that I read in one evening in early May. Cinco de Mayo, in fact - a traditional, Corona-sponsored drinking holiday. Funny how that works. I had requested to receive The Sober Truth totally on a whim and, in reading it, I realize that I have a lot of positive bias toward theraputic environments and coping strategies that the Dodes don't necessary share. I see the benefit of familial support, the relinquishment of power, and righting of wrongs that the 12-step program has and the absolute crucial factor of a rehabilitation environment for safely detoxing their clients. This makes this book somewhat hard to hard and easy to judge as a list of harsh assumptions about something that's unapologetically unempirical.

  26. 4 out of 5

    Rob Dinsmoor

    Dr. Dodes takes on the claims made about Alcoholics Anonymous, arguing convincingly that there is scant scientific background to supports its effectiveness and highlighting the downside of buying into AA's philosophy and approach. With this, I have no problem with. My only objection is that he appears to very casually dismiss the idea that there is a biological component to long-term addiction. He argues something to the effect, "If exposure to alcohol were enough to cause addiction, then everyo Dr. Dodes takes on the claims made about Alcoholics Anonymous, arguing convincingly that there is scant scientific background to supports its effectiveness and highlighting the downside of buying into AA's philosophy and approach. With this, I have no problem with. My only objection is that he appears to very casually dismiss the idea that there is a biological component to long-term addiction. He argues something to the effect, "If exposure to alcohol were enough to cause addiction, then everyone who ever took a drink would be an alcoholic." This type of argument is a tad facile, dismissing the idea of a genetic component as carelessly as he dismisses a biological component. Nonetheless, I found it great reading and would highly recommend it to anyone who is considering (or has already been disappointed by) a 12-step program.

  27. 5 out of 5

    Kate

    I really didn't love or hate The Sober Truth. I thought this book had some limitations. Dodes' major criticism of 12-step programs is the ineffective research, and low success rate. Yet, Dodes advocates his use of psychodynamic therapy to be a better solution to treating addiction, but doesn't provide adequate research to substantiate this argument. I do agree that 12-step programs are not a one size fits all solution to overcoming addiction. However, some people simply cannot afford 1 hour a we I really didn't love or hate The Sober Truth. I thought this book had some limitations. Dodes' major criticism of 12-step programs is the ineffective research, and low success rate. Yet, Dodes advocates his use of psychodynamic therapy to be a better solution to treating addiction, but doesn't provide adequate research to substantiate this argument. I do agree that 12-step programs are not a one size fits all solution to overcoming addiction. However, some people simply cannot afford 1 hour a week of psychotherapy. While, psychodynamic therapy may have worked for some of Dodes patients, I do not believe that all patients will have the same success rate by a practitioner using only a psychodynamic theoretical orientation. People are too complex to be reduced to any one size fits all approach whether it be psychodynamic therapy or attending 12-step programs.

  28. 5 out of 5

    Matthew Lawrence

    It's not the most compellingly written book-actually, it feels like the authors went to a great lengths to stretch it to 160 pages at all-but it's a really interesting subject. I didn't realize that AA success rates are as low as they are (10% on the high end) but ultimately the book argues the greater point of how psychology is now taking a backseat to biology in addiction studies, largely because pharmaceutical companies are better equipped to fund studies these days. There is also a lot bat t It's not the most compellingly written book-actually, it feels like the authors went to a great lengths to stretch it to 160 pages at all-but it's a really interesting subject. I didn't realize that AA success rates are as low as they are (10% on the high end) but ultimately the book argues the greater point of how psychology is now taking a backseat to biology in addiction studies, largely because pharmaceutical companies are better equipped to fund studies these days. There is also a lot bat the God parts of 12-step programs and how various courts have ruled it unconstitutional for judges to mandate 12-step programs.

  29. 5 out of 5

    Ray

    This is a life-changing book for me. I even plan to buy it, and that's saying something. It is significantly flawed, however. The author, a psychoanalyst, stops his ideas for effective treatment at the door of American individualized psychology models, most notably psychoanalysis, and also supports psychoactive medication. Although both those tools have helped me, I was disappointed that he paid no attention to systems of power and oppression, and the role of community in mental health and substa This is a life-changing book for me. I even plan to buy it, and that's saying something. It is significantly flawed, however. The author, a psychoanalyst, stops his ideas for effective treatment at the door of American individualized psychology models, most notably psychoanalysis, and also supports psychoactive medication. Although both those tools have helped me, I was disappointed that he paid no attention to systems of power and oppression, and the role of community in mental health and substance abuse prevention. Still, his careful pulling apart of AA had me nodding and nearly in tears. Finally.

  30. 5 out of 5

    K Ryan

    What I liked about this book was not so much the anti-AA argument (of which I'm sure there are plenty more out there), but the fact the authors analysed research studies and meta-analysis. What they found was very interesting and there is a definite need for further research into the efficacy of rehab programs, most of which are based on the 12-step model. It did feel a little one-sided at times and I would have liked to hear more from advocates of the 12-step model, in an intelligent argument. What I liked about this book was not so much the anti-AA argument (of which I'm sure there are plenty more out there), but the fact the authors analysed research studies and meta-analysis. What they found was very interesting and there is a definite need for further research into the efficacy of rehab programs, most of which are based on the 12-step model. It did feel a little one-sided at times and I would have liked to hear more from advocates of the 12-step model, in an intelligent argument.

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