For many decades, alcohol treatment programs focused on our drinking problems and the consequences of our actions while drunk. Then they offered instruction in the AA and NA programs of recovery. Most people got well and stayed sober over time. A few simply took this valuable information and stayed sober on their own, perhaps aided by the AA “Big Book” or NA basic text. Most stayed sober in one of the two Twelve Step Fellowships.

Treatment centers helped patients take an honest look at their lives and relationships. They helped people find the link between alcohol or drug use and all the other pain points in their lives. In the 1970’s I visited a Catholic treatment center called Maryville in southern New Jersey. There was a large painted sign in the dining hall, with two sentences painted on it. It read: “The truth shall make you free”, and “But First, It Shall Make You Miserable.”

Many people, upon taking Step Four, a searching and fearless moral inventory of themselves, feel miserable doing it. Then, upon taking Step Five and admitting out loud to God, themselves, and another human being the exact nature of the wrongs they have done, they feel a lot better. As that sign said, the truth has made them free. 

Treatment, followed by AA or NA was simple, and highly effective. So where did this go wrong? It started with a reasonable idea. If treatment centers accepted health insurance, then treatment could be available to a lot more people. Good idea. 

Then treatment centers discovered that insurance give reimbursement for each diagnosis. Insurers paid for alcoholism. They also paid for Post-Traumatic Stress Disorder, and Anger Management, and Gender Identity Issues. One former employer of mine even had specialized groups for “Persons of Means and Prominence” which dealt with the special problems of wealth and fame and billed for them.

I do not minimize problems other than alcohol or drugs. My psychiatrist, who was a professor of psychiatry at Harvard Medical School, told me that I had the worst case of child abuse he had ever seen or read about in a patient who lived. In 1993 I had a brain scan and neurology exam because at age 5 my mother shattered my skull, causing broken skull pieces to cut into my brain. That caused severe migraine headaches all day, every day, for 63 years in a row, until age 68. At age 68 a new class of monthly injectable migraine drugs was invented that gave me and countless others significant relief. 

The neurologist who looked at the brain scan in 1993 told me that my brain damage was consistent with a man who would have trouble walking and talking. I walked and talked, for which he had no explanation, except “Everybody is an individual.”

I had severe and sustained child abuse from age 4 to age 12. That did not cause my alcoholism. Alcoholism has within it, its own cause. It is a neurological, chronic illness that we inherit from our ancestors. 

My psychiatrist asked me why I wasn’t like my family, most of whom were violent alcoholics. I simply answered that I didn’t want to be like them. I said “I want to be a cause of the future rather than a result of the past.“ My parents never got sober, never changed. I am not them. 

AA gives all of us the power of change, which comes from God. Taking all twelve steps changes us. Here’s what our book says about change, on page 25:

“The great fact is this, and nothing less: That we have had deep and effective spiritual experiences which have revolutionized our whole attitude toward life, toward our fellows, and toward God’s universe. The central fact of our lives today is the absolute certainty that our Creator has entered into our hearts and lives in a way which is indeed miraculous. He has commenced to accomplish those things for us which we could never do by ourselves. “