Monday, August 16, 2010

Alcoholic Recovery: Changes In Worldview

By: Gary J. Salton, Ph.D.
Chief: Research & Development

Professional Communications, Inc.


INTRODUCTION

Organizational Development focuses on how the individual contributes to organizational goals. But the current in this stream also runs the other way. Organizations can affect the individual.

This study focuses on 103 recovering alcoholics who are members of Alcoholics Anonymous (AA). They agreed to participate in the research on an individual basis. In compliance with the traditions of AA, there was no participation by the organization itself in any form whatsoever.


The study finds a statistically significant relationship between the length of sobriety and the information processing strategies being used to navigate life. The degree of direction and degree of change are both predictable and explainable.

This study is the evidence-based foundation of a three
research blog
series. Research blogs covering the 12-Steps and another addressing AA organizational factors are available in the Applied Research listing on www.iopt.com. A video summary of all three research blogs in this series can be found at www.iopt.com in the "Coffee Break
Videos" section or by clicking the icon on the right.




PROCESS
Alcoholism is a bio-chemical dependency. It is not a behavioral defect. Information processing elections did not cause the condition and changes in it cannot “cure” the dependency. However, knowledge of the processes involved may help to manage it.

Any form of control is predicated on the information processing strategies. No control system will work if the subject is not paying attention to the control variables. This applies to external controls and those created for self-control by the individual themselves.

Alcoholism is supported by the information processing strategy being used. The strategy consists of accepting a particular form of input, processing (i.e., interpreting) it in a specific way and issuing behavior (i.e., output) of a typical character. Repeated application of this mechanism produces beliefs (e.g., things that continue to work are deemed “true") and values (e.g., the frequency with which a behavioral option tends to be used evidences perceived value).

This process can create “worldview” which is compatible with alcoholism. A change in worldview is an often cited as a condition of maintaining sobriety(1). This is an implied recognition of the centrality of information processing in successfully recovering from alcohol dependency.

The concept of “worldview” is expressed in this study using the term "I Opt" strategic profile. A strategic profile has a specific meaning that can be measured, quantified and tested. It is a superior research tool to the more nebulous concepts of “worldview” that rely on adjectives and analogies for definition.


GENDER DISTRIBUTION OF THE SAMPLE
The research sample included 45 women and 58 men. Graphic 1 compares these proportions to a national sample of about 7,500 members published by Alcoholics Anonymous (2004) (2).


Graphic 1
GENDER COMPARISON OF RESEARCH SAMPLE TO

NATIONAL ALCOHOLICS ANONYMOUS SAMPLE


A z-ratio test for the difference in proportion indicates that gender differences do not rise to levels of academic significance. It is reasonable to judge that the sample to be representative of the roughly 60%-40% split of the larger AA population.

The strategic profiles of males and females within the research sample were compared. The results are shown in Graphic 2.

Graphic 2
MALE AND FEMALE STRATEGIC STYLE COMMITMENT



On average, the two genders are virtually identical in the “I Opt” strategies that they use. Therefore it is reasonable to assume that any discoveries made in this research are equally applicable to both genders.


AGE DISTRIBUTION OF THE SAMPLE
The age distribution of both the research sample and the national Alcoholics Anonymous sample are shown in Graphic 3.

Graphic 3
AGE COMPARISON OF RESEARCH SAMPLE TO

NATIONAL ALCOHOLICS ANONYMOUS SAMPLE

Graphic 3 shows a clear distinction between the sample and the AA population. The average age for the national AA sample was 48 years while the research sample respondents averaged 26.4 years old. This is a marked difference. It gives rise to a key question. Is age related to the choice of the strategic styles used to navigate life?

One way of approaching this issue is to plot age against the strength of a strategic style. Graphic 4 shows the result of this comparison applied to the LP (i.e., disciplined action) style.


Graphic 4
AGE VERSUS LOGICAL PROCESSOR STRATEGIC STYLE


Visually there is no apparent relationship between age and the LP style. An R2 statistic confirms this. R2 describes the degree that a variable (e.g., age) can be used to predict another (e.g., LP style strength). In Graphic 4, age predicts (“explains” in statistic jargon) about 1.5% of the Logical Processor variation. Table 1 shows that the remaining styles also minimal effect.

Table 1
INFLUENCE OF AGE ON STRATEGIC STYLE (R2)


While not conclusive, the data strongly suggests that age and strategic styles are unrelated. This view is confirmed by experience in over 200,000 measurements conducted using “I Opt” technology. It is reasonable to conclude that the age distribution of the research sample will not be an impediment to the conclusions of this research.


SOBRIETY AND “I OPT” STRATEGIC STYLE
The research compared the average strategic style profiles at different lengths of sobriety. The results are shown in Graphic 5.

Graphic 5
STRATEGIC STYLE PROFILE BY LENGTH OF SOBRIETY


Graphic 5 immediately reveals that a systematic process is in operation. For ease of reference, a circled number has been included on Graphic 5 to identify style.

The spontaneous RS (circled 1) column shows a drop (21%) as a person moves from short to mid term sobriety. Disciplined action LP (circled 2) picks up most of this drop by increasing its strength by 43%. This makes some sense. A greater shift to the analytical HA (circled 3—11% increase) would not be of great value to a mind clouded by alcohol. HA understanding must await effective computational resources. Similarly, idea generating RI (circled 4—a 4% drop) is not much affected in this initial phase. It still has value. For example, ideas can be generated showing to how the new LP behavior “fits in” to the person’s life.

Moving from mid to long-term sobriety the average strategic profile changes further. The quick acting RS (circled 1) drops still further but it is NOT picked up by the disciplined LP (circled 2). This again makes sense. At this stage the structured processes of the LP have already been installed. The mind is clearing. Now understanding is needed. The HA strategy responds (circled 3) with a large 36% increase in strength. With this knowledge, the person can fashion strategies that meet the unanticipated challenges that bio-chemical dependency will undoubtedly present in the future.

There is also a drop in the idea oriented RI (circled 4) as a person moves from mid to long-term sobriety. This is probably a secondary effect. Both the RS and the RI operate using unpatterned (e.g., spontaneous) input. The large drop in RS withdrew some of the “raw meat” that the RI needs. Without this “food source” the RI strategy drops in value. Hence the decline in usage.

The fact that there is systematic process is beyond challenge. However, there is a legitimate question as to whether this is just happenstance or if it betrays a fundamental underlying process. This is a question statistical significance is designed to answer. The results are shown in Table 2.

Table 2
STATISTICAL SIGNIFICANCE OF STYLE CHANGES
t-Test Assuming Unequal Variances


The significance tests bear out the logic outlined above. The shift from short-term
RS to mid-term LP and HA styles stand out. Similarly, the shift from mid to long-term in the increased use of the analytical HA strategy fits in. The insignificance of the RI change appears to conform to the judgment that it is a derivative outcome. It is not in the causal chain.

The change in profiles describes a change in worldview. Different inputs are accepted, different processes (e.g., interpretation) are employed and different behaviors (output) are issued. A question remains. How does this fit into the Alcoholic Anonymous recovery program?


FIT WITH ALCOHOLICS ANONYMOUS
The famous AA 12-Steps are literally an exact fit to the results of this study (3). A full specification of the fit is beyond the scope of this evidence based research blog. It is addressed more thoroughly elsewhere (http://garysalton2.blogspot.com). For purposes of this research the logic is just outlined.

The 12-steps can be seen as a blueprint for the design, installation and maintenance of a control system. This perspective fits. AA does not claim cure, just control. Stripped of doctrine and viewed as staged process the 12-steps become guide to control individual information-processing strategies.

Table 3
ORIGINAL 12-STEPS OF ALCOHOLICS ANONYMOUS(3)


Steps 1 through 3 call for surrender and acknowledgment of a knowledge source that is outside of oneself. Accepting these prescriptions mean that addiction can be controlled and there is a way to do it. This is fundamental. Without this belief there would be no motive to abandon the strategy now being used.

Step 4 and 5 call for an inventory identifying behavioral shortcomings. These are to be specified EXACTLY. The BEHAVIORS that require change are firmly targeted. This is ground prep. It will become the scaffold for the structures used by the LP strategy to be adopted. Steps 6 and 7 continue this theme by obtaining an agreement that the identified behaviors require replacement, not just modification.

As progress proceeds though Step 7, behaviors have begun to be modified. Identifying something as “wrong” creates a tendency toward avoidance. Avoidance is a behavior change. Steps 8 through 10 require making amends to the specific people who have been harmed. This is a gut wrenching process that burns in the consequences of the “wrongs” that have been done. A person’s emotional systems are engaged in a massive way. The rational has now been combined with the emotional. The whole brain is now engaged.

Early in this process a sponsor was acquired as a guide to and guardian of the steps. They help insure that self-deception is kept to a minimum. Sponsors offer experience-based options and alternatives. They provide encouragement and act as stimulants to progress. Effectively, their role is to help a person begin to self-construct a behaviorally based framework on which they can rely.

Steps 11 and 12 now kick in. Step 11 calls for knowledge and understanding. To this point “reasons” have not been stressed. During the Phase 1 stage behavior is guided by the sponsor and by inference from the stories in the “Big Book.” The relatively small 11% change in the analytical HA strategy between the short and mid-term stages reflects this lack of “why” emphasis. The picture formed to this point is the installation of a practical behavioral framework fashioned by the individual to meet their own immediate situation.

Step 12 provides a motive continuing the quest. Knowledge is the vector on which the message mandated by Step 12 will be carried. Further, teaching someone else is the surest way of learning yourself. These two steps—11 and 12— almost mandate the use of the analytical HA strategy. And this is exactly what happens. Between the mid and long-term phases of the thought-based HA style increases 37% while the action based LP remains at its higher level without change. The scaffold had already been created. Now it is a matter of strengthening it.

Strategic styles can respond to persistent influences from any source. The 12-steps have built-in methods of controlling for these external influences. Step 10 calls for repeated behavioral reassessment and adjustment. Step 11 creates a continuous process of ever increasing understanding. Step 12 insures that the entire AA process remains engaged on an active level.

There are other tools embedded in the AA arsenal. The participation in AA meetings reinforces as well as introducing elements of social control. The 12-traditions limit external influences from both outside and within AA. The AA system is designed to give the individual an environment in which they can construct their own personally tailored solution.


SUMMARY
This study has provided evidence-based support for the veracity of the AA 12-step system. It has also shown how that system works to produce a systematic change in the way people perceive, understand and operate in the world—a change in worldview (4).

It has shown how the 12-steps can be stripped of their doctrinal element and viewed as a formula for the construction and maintenance of a self-constructed management system. This view does not negate the religious overtones of AA. It just introduces another dimension. Both views can coexist. Acceptance of one does not exclude the other.

Programs trying to emulate the success of AA can benefit by an understanding offered in this analysis. For example, in the AA the subject selects the sponsor themselves and the sponsor agrees to the undertaking. This automatically ensures both parties will understand each other. Non-AA programs tend to rely on assigned counselors. The degree of “fit” between the counselor and client is a matter of chance. We now know how information processing works (i.e., input>process>output) and can measure it. This means that the selection of counselors can be refined with a likely improvement in sobriety outcomes.

Charities and government agencies supporting the recovery of alcoholics might also benefit. They now must rely on a “one size fits all” approach. By introducing measurement, this study offers a vehicle for judging the resources required for a particular person or group. For example, it can be reasonably anticipated that someone highly committed to the spontaneous RS strategy will require support longer than another person who is less RS committed.

The understanding contributed by this research is judged to be material. However, in closing homage must be paid to Alcoholics Anonymous. It is a system that guides a person toward to constructing their own individually tailored solution to help control their affliction. The 12-Traditions protect the process itself from being “taken over” by either internal factions or external agencies. Regardless of the iterative manner in which it was constructed, the work of Bill Wilson and Bob Smith in creating AA bears the mark of genius.


REFERENCES
(1) Referencing the Google Search Engine will produce hundreds of thousands of examples. Citing specific authors to lend credibility or authority to this statement of worldview change in the recovery from alcoholism is superfluous.

(2) Alcoholics Anonymous 2004 Membership Survey. Alcoholics Anonymous World Services' General Service Office. 2005. http://www.webcitation.org/5lyIHfv6f. Retrieved 6-27-2010.

(3) Alcoholics Anonymous (June 2001). "Chapter 5: How It Works" (PDF). Alcoholics Anonymous (4th ed.). Alcoholics Anonymous World Services. ISBN 1893007162. OCLC 32014950. http://www.aa.org/bigbookonline/en_bigbook_chapt5.pdf.

(4) The self-imposed brevity of Research Blog studies preclude elaboration on the implications of these findings. They are set out in greater length on the Applications Research Blog at www.garysalton2.blogspot.com.

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