Alcoholics Anonymous and the Golden Rule of Habit Change

Scientists have now studied it in the last decade or 15 years, and the reason why AA works is that it adheres to the Golden Rule of Habit Change.  

Alcoholics Anonymous and the Golden Rule of Habit Change

Alcoholics Anonymous is a perfect example of the Golden Rule of Habit Change.  AA was actually created essentially by a group of amateurs who were alcoholics themselves who had no scientific background, whatsoever.  And since then, AA has not really changed in 70 years. It’s been sort of frozen in time.  And for a long time, scientists dismissed it as kind of this cult or this fringe activity that they didn’t understand. Yet they knew that for a lot of people AA worked, it cured their alcoholism.  Scientists have now studied it in the last decade or 15 years, and the reason why AA works is that it adheres to the Golden Rule of Habit Change.  


So, for a lot of alcoholics, they essentially have a habit dysfunction where they get into this pattern.  They have a cue, which is, "I feel stressed at work" or it’s after work or "I’ve just become habituated to whenever I fight with my wife or whenever something happens in my life, I go to a bar."  Right?  And at the bar, I find a group of friends or I have a drink and I kind of have this social catharsis, and that’s the reward.  The cue is, I had a bad day at work, the routine is, go to a bar. The reward is, I feel so much better after discussing this bad day at work with my friends at the bar and relaxing a little bit.  

So what AA did is it kept the exact same cue and the exact same reward.  It said, "if you have a bad day at work, go to a meeting instead of a bar."  And at that meeting, talk to a whole bunch of your friends, unload all of your problems, have the same emotional cathartic moment.  We’re going to deliver the exact same reward and we’re going to trigger it with the exact same cue. We’re just going to change the behavior that happens.  So besides the fact that it wasn’t invented or created by people who have any background in science, AA's 12 Steps is one of the most effective ways of changing behaviors.  And it’s because they adhere to this Golden Rule of Habit Change.

In Their Own Words is recorded by experts in Big Think's studio. 

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For the first time, researchers appear to have effectively treated a genetic disorder by directly injecting a CRISPR therapy into patients' bloodstreams — overcoming one of the biggest hurdles to curing diseases with the gene editing technology.

The therapy appears to be astonishingly effective, editing nearly every cell in the liver to stop a disease-causing mutation.

The challenge: CRISPR gives us the ability to correct genetic mutations, and given that such mutations are responsible for more than 6,000 human diseases, the tech has the potential to dramatically improve human health.

One way to use CRISPR to treat diseases is to remove affected cells from a patient, edit out the mutation in the lab, and place the cells back in the body to replicate — that's how one team functionally cured people with the blood disorder sickle cell anemia, editing and then infusing bone marrow cells.

Bone marrow is a special case, though, and many mutations cause disease in organs that are harder to fix.

Another option is to insert the CRISPR system itself into the body so that it can make edits directly in the affected organs (that's only been attempted once, in an ongoing study in which people had a CRISPR therapy injected into their eyes to treat a rare vision disorder).

Injecting a CRISPR therapy right into the bloodstream has been a problem, though, because the therapy has to find the right cells to edit. An inherited mutation will be in the DNA of every cell of your body, but if it only causes disease in the liver, you don't want your therapy being used up in the pancreas or kidneys.

A new CRISPR therapy: Now, researchers from Intellia Therapeutics and Regeneron Pharmaceuticals have demonstrated for the first time that a CRISPR therapy delivered into the bloodstream can travel to desired tissues to make edits.

We can overcome one of the biggest challenges with applying CRISPR clinically.

—JENNIFER DOUDNA

"This is a major milestone for patients," Jennifer Doudna, co-developer of CRISPR, who wasn't involved in the trial, told NPR.

"While these are early data, they show us that we can overcome one of the biggest challenges with applying CRISPR clinically so far, which is being able to deliver it systemically and get it to the right place," she continued.

What they did: During a phase 1 clinical trial, Intellia researchers injected a CRISPR therapy dubbed NTLA-2001 into the bloodstreams of six people with a rare, potentially fatal genetic disorder called transthyretin amyloidosis.

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A better option: The CRISPR therapy produced only mild adverse effects and did lower the protein levels, but we don't know yet if the effect will be permanent. It'll also be a few months before we know if the therapy can alleviate the symptoms of transthyretin amyloidosis.

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If everything goes as hoped, though, NTLA-2001 could one day offer a better treatment option for transthyretin amyloidosis than a currently approved medication, patisiran, which only reduces toxic protein levels by 81% and must be injected regularly.

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