02 July 2010

Daily Digest, 2010.07.01

Yesterday (because I fell asleep early again, before writing this post...and it was marvelous): the mystery of AA; an extension of Hamilton's Rule on kin selection; bad lexical analysis, Obama division; books on bubbles and crashes; vuvuzelas for BP.

An outstanding article by Brendan I. Koerner at Wired on Alcoholics Anonymous: "Secret of AA: After 75, We Don't Know How It Works." A must read.

The article begins with a fascinating history of AA, and then considers the fundamental question of AA: no one really knows why it works or even the extent to which it works. However, two important lines of recent research focus on the importance of AA as group therapy (without a designated therapist), and on the way in which AA may help addicts to reboot the ability of the prefrontal cortext to regulate behavior, after that ability had been broken down through the corruption of the brain's reward system by alcohol.

Some quotes:
It was in June 1935, amid the gloom of the Great Depression, that a failed stockbroker and reformed lush named Bill Wilson founded the organization after meeting God in a hospital room. He codified his method in the 12 steps, the rules at the heart of AA. Entirely lacking in medical training, Wilson created the steps by cribbing ideas from religion and philosophy, then massaging them into a pithy list with a structure inspired by the Bible.
The 200-word instruction set has since become the cornerstone of addiction treatment in this country, where an estimated 23 million people grapple with severe alcohol or drug abuse—more than twice the number of Americans afflicted with cancer. Some 1.2 million people belong to one of AA’s 55,000 meeting groups in the US, while countless others embark on the steps at one of the nation’s 11,000 professional treatment centers. Anyone who seeks help in curbing a drug or alcohol problem is bound to encounter Wilson’s system on the road to recovery.
It’s all quite an achievement for a onetime broken-down drunk. And Wilson’s success is even more impressive when you consider that AA and its steps have become ubiquitous despite the fact that no one is quite sure how—or, for that matter, how well—they work. The organization is notoriously difficult to study, thanks to its insistence on anonymity and its fluid membership. And AA’s method, which requires “surrender” to a vaguely defined “higher power,” involves the kind of spiritual revelations that neuroscientists have only begun to explore.
AA originated on the worst night of Bill Wilson’s life. It was December 14, 1934, and Wilson was drying out at Towns Hospital, a ritzy Manhattan detox center. He’d been there three times before, but he’d always returned to drinking soon after he was released. The 39-year-old had spent his entire adult life chasing the ecstasy he had felt upon tasting his first cocktail some 17 years earlier. That quest destroyed his career, landed him deeply in debt, and convinced doctors that he was destined for institutionalization....
But later, as he writhed in his hospital bed, still heavily under the influence of belladonna, Wilson decided to give God a try. “If there is a God, let Him show Himself!” he cried out. “I am ready to do anything. Anything!”
What happened next is an essential piece of AA lore: A white light filled Wilson’s hospital room, and God revealed himself to the shattered stockbroker. “It seemed to me, in the mind’s eye, that I was on a mountain and that a wind not of air but of spirit was blowing,” he later said. “And then it burst upon me that I was a free man.” Wilson would never drink again.
There’s no doubt that when AA works, it can be transformative. But what aspect of the program deserves most of the credit? Is it the act of surrendering to a higher power? The making of amends to people a drinker has wronged? The simple admission that you have a problem? Stunningly, even the most highly regarded AA experts have no idea.
As a result of these complications, AA research tends to come to wildly divergent conclusions, often depending on an investigator’s biases. The group’s “cure rate” has been estimated at anywhere from 75 percent to 5 percent, extremes that seem far-fetched. Even the most widely cited (and carefully conducted) studies are often marred by obvious flaws. A 1999 meta-analysis of 21 existing studies, for example, concluded that AA members actually fared worse than drinkers who received no treatment at all. The authors acknowledged, however, that many of the subjects were coerced into attending AA by court order. Such forced attendees have little shot at benefiting from any sort of therapy—it’s widely agreed that a sincere desire to stop drinking is a mandatory prerequisite for getting sober.
Yet a growing body of evidence suggests that while AA is certainly no miracle cure, people who become deeply involved in the program usually do well over the long haul.
By way of Jonah Lehrer at The Frontal Cortex, who provides an excellent summary as well as some additional insight.

At least two very important people in my life were serious alcoholics. Both died prematurely, and alcohol (exacerbated by other addictions) certainly played a role in the death of at least one.

My first and most important music theory teacher was Ronald Hurst, a Benedictine monk, Catholic convert, and very gifted composer who had studied with Roy Harris, Hindemith, and Darius Milhaud. (One of my prized possessions is a pair of photographs that once belonged to Ronald: a signed portrait of Milhaud and a second photograph showing Milhaud and a young Ronald hunched over a score.)

Ronald was a tutor, in the best sense: someone who talked and sparred with me as if I were an intellectual equal at a time when I knew next to nothing. I remember fondly our argument—after I proudly demonstrated to him my most recent discovery, the jazz cliche of ending on a 7 #9 chord—over whether one could actually properly say that this chord could be the goal of a final cadence.  The classically-trained Ronald kept objecting that it was a dominant chord, and I kept pointing out that many jazz recordings did, in fact, end on that chord.

Ronald was also a very serious alcoholic, of the sort who had multiple bottles of hard liquor hidden in strategic places (just like in Lost Weekend), including his office where he gave my lessons.  He died in his 50s, at a time when he had also fallen into serious abuse of prescription medication, through having uncoordinated multiple prescriptions from multiple doctors.

My piano teacher when I was first in graduate school was Ed LaBounty, a very talented (and polymathic) composer and pianist (a student of Menahem Pressler), who was likewise a serious alcoholic and chain smoker, who (when things were especially bad) one might find sleeping under one of the Steinways in his studio when one arrived for a lesson in the morning, where (it was clear) he had been all night. A particularly painful memory is experiencing the one solo recital of Ed's that I attended while I was his student, in which he clearly was extremely drunk, and had trouble wrangling the long Scotch-taped series of photocopies of Bartòk's "Out of Doors," from which he was playing because he was not confident enough to play it from memory. 

Although he meant well, Ed was probably the most destructive of my piano teachers (something in which his alcoholism surely played a role) and had I not had the extraordinarily good fortune to find Sally Sargent in Vienna later on, I might well have given up playing entirely.   Ed has throughout my life since then served as a cautionary example to me, of what I absolutely did not want to become.

It is probably not coincidental that both Ronald and Ed had semi-repressed issues over sexual orientation.

To have witnessed two such gifted men and (at least potentially) talented teachers in the process of destroying themselves with alcohol made a very profound mark on me.

I'm sure that many if not most of my readers have had significant people in their lives who were addicted to alcohol, and perhaps destroyed themselves with it.

Yet, as readers of this blog will surely guess, I am uneasy over the central role of "God" in AA.  ("God" or a "Power" is mentioned in six of the "Twelve Steps," and a "spiritual awakening" is mentioned in the twelfth.)

That, however, is probably the subject for another post.

It is ironic that Bill Wilson, the founder of AA, seems to have been killed by his addiction to cigarettes. As Koerner writes:
By the early 1950s, as AA membership reached 100,000, Wilson began to step back from his invention. Deeply depressed and an incorrigible chain smoker, he would go on to experiment with LSD before dying from emphysema in 1971.

Razib Khan at Gene Expression (the Discover version) has an excellent post on Hamilton's Rule, occasioned by a new paper in Science:
Jeff Smith, et al. (2010), "A Generalization of Hamilton's Rule for the Evolution of Microbial Cooperation."
The abstract is here. The article is behind a paywall and costs $15.00 for 24 hours of access. Fortunately Razib does a terrific job of summarizing.

Language Log is your best site for quite a lot of issues in linguistics, and is essential for informed critiques of the current media mania for parsing the vocabulary and syntax of Obama's speeches in order to "prove" any number of silly things. In a post on Thursday (yesterday), Mark Liberman utterly disassembles Kathleen Parker's unutterably silly piece (which I won't dignify by linking to) claiming that Obama "writes like a girl" because (allegedly) he frequently uses passive voice. Liberman ends with the lovely put down:
Parker's lizard brain, I'm sorry to say, seems to have the agenda of promoting — with less than no evidence at all — one of the currently fashionable journalistic tropes about Obama.

Charles Morris is interviewed by The Browser on his five recommended books on bubbles and crashes, all of which sound worth reading. Recommended.

Via BoingBoing, a project at Kickstarter to raise money to buy 100 vuvuzelas and hire 100 vuvuzela players to play in front of BP's international headquarters in London all day every day until the Gulf oil gusher is fixed.  (As of the time I'm writing this, the project has already raised $3000, given an original goal of $2000.)

BP headquarters is kind of a long commute from Roslindale, but I'd be happy to blow the vuvuzela at the new BP station on the corner of Belgrade and Centre in West Roxbury.

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  1. Love the BP vuvuzela idea for BP headquarters. Bring it on.

    The status of the station on the corner of Belgrade and Centre Sts is more complex. Independently owned and operated by an immigrant family who have poured everything into the service station over the past several years. They are courteous, expert at repairs, and easy for non-mechanical customers (moi) to talk to and deal with. They recently changed brands of oil for the station from an unknown brand to BP (prior to the spill)... They are the ones who would be hurt most by a local boycott or demonstration of any kind -- not BP. Just shows how complex our international and neighborhood relationsips can be.

  2. Thanks for highlighting the Wired article. David Brooks in the NYT had an interesting column on it this week as well.

    I find the discussion about AA in the press this week fascinating. AA has worked for me for 32 years. Not sure I care why. FYI, from the beginning I was assured that the reference to "god" in the literature could simply stand for "group of drunks". I learned in AA to "take what you need, and leave the rest"...a big reason why it is helpful for so many. Thanks for the discussion.

  3. Thanks to nj for the comment on the West Roxbury BP station. I hadn't realized that the station had stayed in the same hands, and you're right that the situation with local businesses is complex. So I take back what I said about vuvuzeling them.

    It does strike me that they don't seem to have been doing much business when I drive by lately...but I think it must be difficult to compete against the Hess across the street.

    Thanks again for commenting. (This blog is still new enough that I get very excited when I see that anyone is actually reading.)

  4. Anonymous,

    Thanks for the reference to the Brooks column, which I didn't know about. I'll take a look at it.

    Love "group of drunks" for "god." I was fascinated to learn more about the leaderless organization model of AA groups. I'd heard about this, but hadn't looked into it. Now thanks to the Wired article, I've read through the 12 Traditions, which I hadn't known about.