A long-term member of Alcoholics Anonymous, who is an attorney and I recently had a conversation. It was our first meeting and it was moments before my first speech as Health and Well-being Chair. His first statement to me after hello was that he did not agree with my statement that stress and mental illness caused people to abuse substances. After I picked my jaw up off the floor, I responded that I believed medical evidence was on my side and that he should consider the coexisting (comorbidity) condition research. After all, fifty percent of people who drink are depressed and even if they don’t have a mental illness when they start drinking or consuming the addiction can trigger a disorder. My colleague’s response was that the medical community treats the addiction first so it couldn’t cause the abuse or they would do the opposite. Eventually, we agreed to disagree and he actually stayed and listened to my speech.
The conversation stuck with me for a week or so. For years, I have been reading, or shall I say, absorbing, all the information I could find on neuropsychology, psychology and addiction. Recently, in preparation for this speech I even attended a NAMI seminar on comorbidity of mental illness and substance abuse. Was I misinformed? What in the world did AA teach people about their brain and mental health?
So, I spent some time online researching AA and its role in helping people obtain and maintain sobriety. I even put an app on my phone so I can read the Big Book as it is known. What I discovered were sentiments such as “AA is a cult”. That seemed a little extreme. Yet, there is some element of AA which tends to be insular in nature. And, then there are parts of program that have very religious overtones. After all AA’s twelve steps contain many mentions of the “power greater than ourselves” and mentions to God “as we understood him”.
Clearly, AA works for many people. Some people have used the supportive nature and sponsor system to obtain and maintain sobriety for decades and or a life time. But, only 5% of AA members make it to one year. In fact, many relapse and some never maintain a sober life. AA does not work for everyone and there are other support groups and alternative treatments to assist struggling attorneys in their battle against addiction. AA is a support group and as a social support group it works well. It is not psychotherapy and it should not be used as a substitute for psychotherapy.
Why then is AA so prevalently used by Lawyers Assistance Programs? I think that answer is simple-most Lawyers Assistance Programs were started by recovering alcohol judges and lawyers. But, the bigger issue is how can we as lawyers provide complimentary programming to lawyers with substance abuse AND mental health issues? Or even more basic, should we? My answer to this is simple. YES. It is time that science, psychotherapy and AA be used in combination by Lawyers Assistance Programs throughout this country to help struggling attorneys.
Recently, I asked a different colleague, one who helps struggling attorneys, to take me to an AA meeting. I also told him about my interaction with the long time AA attorney. The phrase he used sums up the problem in a nutshell -“there are a lot of ill people at AA meetings”. Now, this is coming from a man who knows the legal system and the problems lawyers face. He helps lawyers in crisis. He explained to me that AA is about accountability and that some AA members have lots of mental health issues. Of course, he has promised to take me to an open meeting to learn more about the program.
So, my question is – why is our profession relying on AA to support attorneys in recovery. Is it just because it has helped those in charge of the Lawyers Assistance programs quit or just because “we have always done this”? Isn’t it time to face the reality that many people need more than AA. Are we setting people up for failure? Is the use of AA promoting a religion and insisting troubled lawyers adopt a faith-based system?
I am going to be asking all of these questions and reporting back on my findings. First, I am going to a meeting and if there are lawyers there I am going to ask them why they drink and if the practice of law contributed in any way to their addiction. Further, I want to know what if anything the bar association could do to stop others from developing addiction issues. Then, I am going to review some disciplinary case statistics and just see how well the AA solution has worked for lawyers in crisis. Updates will be forthcoming.