Book Review: “Her Best Kept Secret: Why Women Drink-and How they can Regain Control,” by Gabrielle Glaser

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This book disappointed me. The title suggests a book of interesting research and conjecture about the reasons women drink. I was hoping for new insights that I could use in my practice with patients who drink alcohol. As it turned out, most of the book wasn’t about what the title implied. That topic was lightly touched on in the beginning, and there was a bit of summary at the end, but way too much of the book was about why AA sucks and why women don’t get the right treatment.

I liked the first third of the book, as it was basically history of alcohol and history of addiction treatment. She wrote about the shame women feel about having alcohol addiction, but that was brief. Overall, that portion of the book was mildly interesting, if a little tedious.

Then the next third of the book felt like an attack on AA. I admit I’m sensitive to AA bashing. I know AA works for many people, and I also know AA has never claimed to be the answer for every problem drinker. Given AA’s stance of “we will help you if you want help,” I don’t think it’s productive to berate the organization if you don’t want to go to their meetings.

My own opinion is that if you don’t like AA or don’t think it works for you, then fine. Take your ass on out of the meetings and go find another way that helps you. After all, AA members are under no obligation to help anyone; they help only because they want to, because it helps keep them sober. They don’t recruit new members, and they don’t ask for any money.

The author’s logic isn’t consistent. First she says AA isn’t helpful for women because it tells them they have to admit powerlessness and that interferes with women’s recovery process, rather than helping it. She says it’s insulting for women to be told that “your best thinking got you here,” and the slogans are too trite or hackneyed to help intelligent female problem drinkers who have problems with alcohol. She says women should be told they do have the power to make changes and stop drinking.

But then the next section, she says women are often victimized by men in meetings who have more time in sobriety, and thus more able to take sexual advantage of the fragile newcomer women. So which is it? Are the newcomer women tender blossoms with have no idea how to thwart a creepy man’s advances? Or are these women so powerful and capable that the simplicity of AA is insulting to their intelligence and capabilities?

Alcoholic Anonymous is made up of humans. Humans with drinking problems. It seems disingenuous to expect these humans to behave better than people in other human organizations (Catholic Church, for example). Also, I suspect some alcoholic women may have encountered creepy male advances in bars.

What kind of treatment does this author say works best? She correctly champions cognitive behavioral therapy and Motivational Enhancement therapy.

As an example, she describes an excellent treatment program that consists of treatment sessions from two therapists, with the addition of other services as needed (primary care consult, mental health provider). This treatment is done as an outpatient, where the person stays in a nice hotel close to the therapists’ office.

It costs ten grand. Ten thousand dollars.

This author gushes about how these therapists are so caring and dedicated that they even eat lunch with the patient. I would hope so. If I were paying ten thousand dollars for a few weeks of therapy, I’d expect my therapists not only to eat lunch with me, but also tuck me in at night and tell me a bedtime story!

So overall, I don’t think the ideas in this book extend to any new territory. Twelve step bashing has been done by many authors, so that’s dull. I found much of the book to be derivative, containing ideas from earlier books about women and addiction. Plus, I was surprised by how little time this author spent describing real barriers many women face when they are seeking help for alcohol addiction. For example, women are the primary caregivers for their children. Male partners may not want to take over childcare responsibilities while the woman gets treatment. Many times the woman’s partner is also in active addiction, and seeks to deter or undermine her efforts to get help and to stay in recovery. Transportation is a big problem, especially in rural areas with no public transportation. She may not have a car she can drive to treatment each day.

These issues were not addressed at any depth.

If you want to read a book about women and addiction, I highly recommend you read, “Substance and Shadow,” by Stephen Kandall, or “Women Under the Influence,” by the CASA program. Both are better written and with more information.

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4 responses to this post.

  1. Posted by Joy Auren on March 15, 2015 at 1:45 pm

    Always good keeping us in know! 🙂

    Reply

  2. Posted by Theodore D Fifer MD FACS on March 16, 2015 at 10:11 am

    Thank you, Dr. Burson, for your candor. Frequently, titles are assigned by publishers to stimulate sales more than describe. It’s good to have an independent review.

    Reply

  3. It gets tiring to hear from people who have made their entire purpose bashing approaches that they dont like especially Park Ave. type therapists. The idea that one approach is empowering and another isn’t is silly. Most women I ask about this say that they feel empowered and strong when they engage in a recovery process that may include Mutual Aid support. Most in recovery feel that many tools and resourcse help over time so taking anything off the table from meds to AA seems cruel since whos to say what will work and when.

    A common misunderstanding is that things are “required” in these programs when thats not the case. Most intelligent beings choose what they like or dont like at any meeting or leave. The aknowlegement about being powerless over the drug is seen as a road to empowerment. I see it like Zen like acceptance.

    Men and women get hit on everywhere. College campuses, Methadone Clinics, therapist waiting rooms, Smart Recovery Meetings, at the gym, walking down the street. So if the goal is to get everyone to pay 10K to stay in a Manhatten Hotel with a bunch of therapsts how is that going to work for 99% of those struggling with a SUD?

    The underpinning of many of these articles is a disregard bordering on hostility for people in this type of recovery many of whom have gone on to get degrees and licenses and are in the field or who “give it away” for free.

    Reply

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