1: The year was 1934.  One of the largest and most successful attempts at wide-scale habit change was about to begin.

Bill Wilson, a thirty-nine year old alcoholic, sat in a dreary basement on the Lower East Side of New York City.  He was drinking three bottles of booze a day.  His marriage was falling apart.  His career was at a dead end, Charles Duhigg writes in The Power of Habit.

He poured his old drinking buddy a glass of gin and pineapple juice.  His friend shook his head.  He explained he’d been sober for two months. Bill was astounded.  He had tried to quit, but had repeatedly failed.  “He’s been to detox and had taken pills.  He’d made promises to his wife and joined abstinence groups.  None of it worked,” Charles states. “I got religion,” the friend said. He talked about hell and temptation, sin and the devil. “Realize you are licked, admit it, and get willing to turn your life over to God.” Bill thought his friend had lost it.  “Last summer an alcoholic crackpot, now, I suspected, a little cracked about religion,” he later wrote.  After his friend left, Bill finished the bottle of gin and went to bed.

One month later, Bill checked into a Manhattan detox center.  A doctor gave him hourly injections of a hallucinogenic drug called belladonna, a popular treatment for alcoholism at the time. It didn’t go well.  Bill began writing in agony.  He hallucinated for days.  His withdrawal was so bad he felt insects were crawling across his skin.  He was nauseous and the pain was so intense he couldn’t stay still.

“If there is a God, let Him show Himself!” Bill yelled.  “I am ready to do anything. Anything!”

At that moment, “a white light filled his room, the pain ceased, and he felt as if he were on a mountaintop, ‘and that a wind not of air but of spirit’ was blowing.  And then it burst upon me that I was a free man,'” Bill later wrote.

Bill Wilson would never drink again.  For the rest of his life, he dedicated himself to founding and building Alcoholics Anonymous.  It would become “the largest, most well-known and successful habit-changing organization in the world,” writes Charles.  

As many as 10 million alcoholics have become sober through the group.  While AA doesn’t work for everyone, millions credit the program with saving their lives.  “The famous twelve steps have become cultural lodestones incorporated into treatment programs for overeating, gambling, debt, sex, drugs, hoarding, self-mutilation, smoking, video game addictions, and emotional dependency.”

What’s surprising is that AA doesn’t directly address the biochemical issues researchers believe are at the core of why people drink.  Moreover, there are no “professionals” who guide AA meetings. “What AA provides instead is a method for attacking the habits that surround alcohol use.  AA, in essence, is a giant machine for changing habit loops,” Charles observes.  The AA approach disrupts old routines by changing the “habit loop.” “Researchers say that AA works because the program forces people to identify the cues and rewards that encourage their alcoholic habits, and then helps them find new behaviors.” Step four demands we make “a searching and fearless inventory of ourselves.  In step five we admit “to God, to ourselves, and to another human being the exact nature of our wrongs.”

What’s going on here?  

“It’s not obvious from the way they’re written, but to complete those steps, someone has to create a list of all the triggers for their alcoholic urges,” Charles observes.  “When you make a self-inventory, you’re figuring out all the things that make you drink. And admitting to someone else all the bad things you’ve done is a pretty good way of figuring out the moments where everything spiraled out of control.” AA also asks us to search for the benefits we get from drinking.  “What cravings, the program asks, are driving your habit loop?” Interestingly, intoxication often doesn’t make the list.  “Alcoholics crave a drink because it offers escape, relaxation, companionship, the blunting of anxieties, and an opportunity for emotional release,” Charles writes.

These cravings for relief occur in a completely different part of the brain than the craving for physical pleasure. AA structures its program to provide alcoholics with the same rewards they receive from drinking.  “AA has built a system of meetings and companionship—the ‘sponsor’ each member works with—that strives to offer as much escape, distraction, and catharsis as a Friday night bender,” comments Charles. “You can relax and talk through your anxieties at the meetings. The triggers and payoffs stay the same, it’s just the behavior that changes,” says J. Scott Tonigan, a researcher at the University of New Mexico, who has studied AA for more than a decade. There is one other element that helps alcoholics in addition to habit replacement. “Over and over again, alcoholics said the same thing,” Charles writes.  “Identifying cues and choosing new routines is important, but without another ingredient, the new habits never fully took hold. The secret, the alcoholics said, was God.”

Charles quotes John, a self-described former atheist: “Without a higher power in my life, without admitting my powerlessness, none of it was going to work,” he reflects.  “I knew that if something didn’t change, I was going to kill my kids.  So I started working at that, working at believing in something bigger than me.”

The final, essential factor?   

“Belief was the ingredient that made a reworked habit loop into a permanent behavior,” Charles writes.

More tomorrow.


Reflection: What sense or meaning do I make from the story above?

Action:  Journal about it or discuss with a friend.

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