How the Science of A.A. Explains Whitney Houston’s Death
It’s easy to forget, given her scandal-tinged life and tragic death, how incredibly talented Whitney Houston was. She holds the world record as the most-awarded female act of all time, with over 415 major recognitions during her career. She is the only artist to chart seven consecutive number one songs.
And she was smart: every time she fell from grace – a disastrous marriage, admitting to drug use on national television, narrowly fleeing arrest when drugs were discovered in her luggage by jumping onto a departing plane – she rehabilitated her public image with an astoundingly savvy move: starring in a hit film, going on Oprah, becoming the unexpected (and sympathetic) star of a reality television show.
So why, given Houston’s obvious and prodigious talents, did she fail at rehab so many times? And why – as is now suspected – did she have such little control over a drug habit that it took her life?
Because she was too talented. Because 12-step programs are predicated upon learning to believe in a group – and someone as unique and famous as Houston will always be an individual first. What happens psychologically when you become a diva, it turns out, makes it almost impossible for rehab to succeed.
To understand why, consider the amateurish and completely unscientific origins of the first 12-step program, Alcoholics Anonymous.
A.A., in a sense, started in 1934 when an alcoholic named Bill Wilson checked into an upscale Manhattan detox center. It wasn’t his first visit. He’d been to other centers. He’s gotten into fights – including one at a country club that had cost him his job. He’d made promises to his wife and joined abstinence groups. None of it had worked.
Inside the Charles B. Towns Hospital for Drug and Alcohol Addictions, a physician started hourly infusions of a hallucinogenic drug called belladonna. Wilson floated in and out of consciousness. The withdrawal pains made it feel as if insects were crawling across his skin. “If there is a God, let Him show Himself!” Wilson yelled to his empty room. At that moment, he later wrote, a white light filled his room, the pain ceased, and he felt as if he were on a mountaintop. “And then it burst upon me that I was a free man,” he later wrote.
Wilson would never have another drink. For the next thirty-six years, he would devote himself to building Alcoholics Anonymous by essentially making up – out of thin air – the rules that today help an estimated 2.1 million people each year. (The program’s famous 12-steps, for instance, were written by Wilson in a rush one night while siting in bed. He chose the number 12 because there were 12 apostles.)
What’s interesting about AA is that the program doesn’t directly attack many of the psychiatric or biochemical issues that researchers say are often at the core of why alcoholics drink. In fact, AA’s methods seem to sidestep scientific and medical findings altogether. What AA provides instead is a method for attacking the habits that surround alcohol use. AA, in essence, is a giant machine for changing the habits in peoples’ lives.
For years, A.A. was seen among researchers as almost a cult, an unscientific backwater hardly worth mentioning, much less studying. But about a decade ago, attitudes began to change. Scientists noticed that over 10 million Americans had credited their recovery to A.A.. Something that helped so many people, academics figured, must be doing something right.
And so a series of studies began exploring precisely why A.A. was so successful. The first big lesson was that A.A. worked by slightly tweaking comfortable habits. A.A., for instance, provides people with the same cues and rewards they’ve always been accustomed to. All it does is change the routine. Many alcoholics, say studies, essentially suffer from habit dysfunctions. They have learned to react to a cue (“I’m stressed. I need to relax at a bar.”) with a routine (“Bud Light, please.”) to receive a reward (“I always feel better after unloading to my friends over a beer.”)
A.A. just tweaks that formula slightly. There is a still the same basic cue (“I’m stressed. I need to relax at a meeting.”) a slightly different routine (“My name is Jim, and I’m an alcoholic.”) and, essentially, the same reward (“I always feel better after unloading to my friends over coffee.”)
Anyone – including Whitey Houston – can take advantage of this basic therapy. (And, in fact, Ms. Houston did numerous times, to apparent – short-tem – success.)
But eventually, researchers started asking another question: if A.A.’s ability to change habits is so effective, than why does it eventually fail for so many people? In other words, why do some people fall off the wagon, while others keep their new sober habits for years?
Researchers began finding that habit replacement worked pretty well for many people until the stresses of life — such as finding out your mom has cancer, or your marriage is coming apart — got too high, at which point alcoholics often relapsed. One group of researchers at the Alcohol Research Group in California began conducting interviews, and found that the difference between people who stayed sober, and those who re-succumb to addition, was that the sober participants had learned how to believe in something. Practicing at belief inside A.A. meetings was a skill that eventually spilled over to other parts of their lives – until they started believing they could change.
“At some point, people in A.A. look around the room and think, if it worked for that guy, I guess it can work for me,” Lee Ann Kaskutas, a senior scientist at the Alcohol Research Group, told me. “There’s something really powerful about groups and shared experiences. People might be skeptical about their ability to change if they’re by themselves, but a group will convince them to suspend disbelief. A community creates belief.”
And this helps explain why programs like A.A. worked so well for Whitney Houston – as long as she was inside a rehab center – and why they fell apart when she got out. For one thing, according to reports, Ms. Houston often returned to the same environments and people who had previously triggered her abusive tendencies. But that shouldn’t make it impossible to stay sober. Most former addicts don’t have the money or ability to change their homes or find new friends or families once they kick their bad habits – and yet they stay away from beer or drugs nonetheless.
But what Ms. Houston couldn’t do – because her life catered to the belief that she was peerless, the star of the show, an incomparable diva – was find a group of peers whom she could compare herself to, and believe that if they can struggle and persevere, so can I. Her life was not constructed to subsume her ego into the communalism of a group. And so she never found a safe place to practice believing she could change. And so as soon as the pressures hit, all the new habits broke down, and the old patterns took over.
Which raises a tough question: how can people who are talented and successful in many realms find opportunities to attack their worst habits? How does someone running for President (or within the Oval Office) create a structure that allows them to change their worst habits? What powerful and talented people have you seen struggling with bad habits? How did they figure out how to change them?
Some of the ideas and portions of this post draw on my book, The Power of Habit