SHAY: It is another wonderful day to be a humanist. Welcome to How to Humanist, the podcast. I am your host, Shay Leonia, back for another one. I feel like we're starting to get a little, you know, greased up — nice and groovy here. How are you feeling?

Today we have another awesome guest, but before we get into him, I want to recognize two pretty badass people that I discovered just last week.

The first one is Enne. If you're listening, Enne wrote in and let us know that they have absolutely fallen in love with the podcast. I believe the quote was, "I'm crazy about your podcast," which of course launched my jukebox mind into a twofer. We got some "Crazy About You," some Funny Girl, and then we also had some Madonna "Crazy for You." So it was like both songs were playing at the same time. Don't even ask how that happened. Did my brain turn it into a round? No. We were just like, both sides of the brain were fully activated.

But anyway, Enne, back to you — thank you so much for writing in because any opportunity to compliment me on how I'm doing hosting this show... no, seriously, it's very helpful. Thank you very much. I'm so glad that you have discovered the AHA and humanism and all of its glory. We are so excited to have you in the community.

And then the other person I wanna shout out — I actually don't know their name, but I don't know how many people have taken a tagline that I've come up with, namely "Humanity is Enough," and got it tattooed on their arm. I get to add to my resume now that I came up with a tagline that somebody actually inked on their arm. And I am a huge fan of tattoos. I don't know if you're listening and if you're also a fan of tattoos, please feel free — as long as they're on an appropriate body part — feel free to send me some photos of your tattoos. Especially if you have some humanist ones. Those would be super cool. I wonder how many of you listening have like a Kurt Vonnegut tattoo or something.

Anyway, one of the things I want to bring up today before we get into our guest is the Religious Liberty Commission. It seems like the media is crickets on this, and it is one of the biggest jokes — but also a dangerous joke — that everybody needs to be paying attention to.

"Cankles," as Jennifer Welch from the I've Had It podcast appropriately deemed him — the Religious Liberty Commission is a federal advisory body tasked with creating a comprehensive report. I'm reading Wikipedia right now: on the foundations of religious liberty in America, the impact of religious liberty on American society, and current threats to domestic religious liberty, as well as strategies to preserve and enhance religious liberty protections for future generations, and programs to increase awareness of and celebrate America's peaceful religious pluralism.

It's bullshit, bullshit, bullshit, bullshit, bullshit. This is literally just a farce so that he can push a Christian nationalist agenda. We have been paying very close attention to any time that they have gathered, including Dr. Phil. Ugh. Yeah. Dr. Phil is a part of this Religious Liberty bullshit.

I can tell you that they are doing anything but trying to protect Americans' rights to religious pluralism. That's not what they're up to over there. They are up to things like letting people that run homeless shelters turn trans people away. They're just up to a whole bunch of dangerous nonsense.

So I just really would love for you all to pay attention to the Religious Liberty Commission. And there's no better way to pay attention to it than to be sure to join the AHA. Sign up on our newsletter — we keep you all informed of what's going on there. You can visit americanhumanist.org/join. That's the easiest way to get involved, and we have so much for you to get involved in.

Let's move on to today's guest. We have none other than Joe Gerstein — Dr. Joe Gerstein — who is the founding president of SMART Recovery. SMART Recovery stands for Self-Management Addiction Recovery Training. It's a nonprofit secular mutual aid group program now available in 38 countries and in 16 languages. He's a retired Harvard Medical School professor who has facilitated over 4,000 SMART meetings and 800 in prisons. Whew.

I don't think I've ever wanted somebody to like me so much as I wanted Joe to like me throughout this interview. He is fascinating. I really hope you enjoy this.

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SHAY: It's so wonderful to meet you. First of all, thank you for taking the time to come and join me on this.

JOE: Always glad to talk about SMART Recovery, or as we say in Boston, SMART Recovery.

SHAY: Is that where you're from? Boston?

JOE: Yeah. Can't you hear that? But I actually invented the name, which was pretty dumb because I couldn't pronounce it. But after 10 years, I learned how to say SMART Recovery.

SHAY: That is brilliant. Oh my gosh. I can relate because I'm from Jersey, but from like right outside the Bronx, so a lot of people — I'm from Jersey. Yeah. Oh, that is so cool. So you're born and raised in Boston.

JOE: Yeah.

SHAY: Wow.

JOE: I'm now in Miami. Many Bostonians. Yeah. I have a son who lives seven blocks away, so I'm pushing 90, so it's time to be near one of your kids, at least.

SHAY: Stop. You're pushing 90. Wow. Congratulations.

JOE: Still punching.

SHAY: Yeah, thank you for still being here and kicking and all of that great stuff. Okay. I know that you've spoken on many a podcast, but I want to cover like the foundational stuff. I'm sure you've told your story a hundred times, but I also spoke to somebody that is very close to me who was very excited that I'm talking to you and was bewildered by the idea of secular recovery.

JOE: We've only been at it for 35 years.

SHAY: Yeah. Relatively new. Okay. Gosh, what do I want to ask first? What was your history, if you don't mind sharing, with addiction?

JOE: I'm a workaholic. That's it.

SHAY: Got it. Okay.

JOE: Yeah. I'm a physician, so I had contact with people who tried AA and NA, who had problems but it didn't work for them, or they didn't like it for religious reasons or autocratic reasons, or they didn't accept the idea of powerlessness or whatever. And they were just orbiting around. This was 1989, 1990, when insurance didn't cover any outpatient activities. And when we call these groups self-help groups — now we know a lot more about how they work, so we call them mutual aid groups.

SHAY: I didn't even know that language had changed.

JOE: Matter of fact, SMART is an acronym — Self-Management Addiction Recovery Training. So it derives from that era.

SHAY: Can you go more in depth about, aside from them disagreeing with the religious part of it — were these people trying to adapt?

JOE: There really was no other free mutual aid option available at that time. Two groups started up. One was called SOS — Secular Organization for Sobriety — and the other one was called Rational Recovery. Rational Recovery eventually, after four years, morphed into SMART Recovery, became a nonprofit organization, and so forth.

And then it was available, but it wasn't commonly known. And of course we only had in-person meetings. So if there wasn't a meeting in your town or in your section of the city, you didn't have access. And then in 1996, meetings where you could type in your comments — the bandwidth wasn't enough to allow speech or certainly vision.

And then gradually, COVID came along and we switched to 700 Zoom meetings from about 2,300 in-person meetings. And we spread around the world. I'm married to an Australian, so we went to Australia. There are now 347 weekly meetings there. We went to the UK, to Scotland — she has a Scottish background — and in the Inverness Prison we started, and now there are about 500 meetings a week in the UK. And the rest is, as they say, history.

SHAY: I love that you married somebody who was Australian.

JOE: We met in the Bronx. How do you like that?

SHAY: Then the mixture, the gumbo of accents. I can only imagine. Meeting in the Bronx — an Australian with a Scottish background —

JOE: And a Bostonian. That's hilarious.

SHAY: Municipal hospital. Wait, so was she working at the —

JOE: Yeah, she was a nurse. She was an exchange fellow. Yeah.

SHAY: Okay, so can you set me straight? What did you create SMART Recovery?

JOE: No. I heard Jack Trimpey talk about his Rational Recovery program at the AHA conference in Sacramento in 1989.

SHAY: Really.

JOE: And I was goaded by a priest. I had a couple of good friends who were priests. One was a Jesuit, one was a Dominican. And that guy was a real saint kind of guy — would hear about a gang fight, gonna go take the guns away from kids.

SHAY: Wow.

JOE: Really amazing person. He told me once, he said, "You humanists just like to talk. Why don't you do something for people directly?" I was the president of the Humanist Association of Massachusetts, and indeed he was correct. It was a small organization, maybe 40 or 50 people, but from a very wide geographic area. It's tough to corral them anyway. But I took it to heart what he said, and I was looking for something.

We tried to do like a soup kitchen with a Unitarian church — that didn't work out. And then I heard Jack Trimpey talk about his program, which was a science-based secular program. And I got friendly with him and I got a small grant from the AHA and I invited him to Boston. I set up a radio talk show appearance, I got an article in the Boston Phoenix Weekly newspaper, and I arranged a talk at Harvard in the Science Center. But out of that only came one meeting. I was extremely busy at that time. I had no intention of getting deeply involved. I didn't know anything about cognitive behavioral therapy, which was just beginning to come in when I was in medical school. I didn't believe in it actually. I said, I don't think you can talk people out of severe depression. I don't see how it can be done. It was the beginning of pharmacology for depression.

The one group got started in the basement of Memorial Hall at Harvard, and then they started fighting with the facilitator, who was a social work student. Eventually they wanted me to come and run a meeting. I didn't know anything, and I hadn't even read Jack Trimpey's book until about a year before. I stumbled through the meeting and I said, that's the end of this whole project. I put a lot of time and energy into it, I was gonna flame out, and I was leaving the room and somebody said, you're coming next week, aren't you?

I said I hadn't planned on it. I'm very busy, blah blah blah. And I said okay, I'll come once more while I look for a facilitator. Anyway, I got hooked on it. After the sixth meeting I said to myself, this program is going to change the world. I never said that to anybody else because they would put me away.

They had about 10,000 meetings in the US alone. But anyway, there you are. We're in 38 countries, 16 languages, maybe a few more even now. I don't follow it that closely. And that's it. And we're accepted by all the government agencies. In the New England Journal of Medicine, in the first four months of 2025, there were three articles about addictions — all of them by prestigious authors, all of them recommending SMART Recovery along with AA. It's now well accepted, at least in the academic community, and I think probably by now most professionals in the area have at least heard of it, which doesn't mean they use it.

So we're in a different trajectory now. It's a small nonprofit with about 4,000 volunteers. That's it. It's moving ahead slowly. We have a family and friends program too — a science-based program — and we have a trio of programs for prisons, jails, and reentry programs.

SHAY: Wow.

JOE: We introduced it to the UK through the Inverness Prison in Scotland. I went back there about two years later — they asked me to come back. One of their corrections officers had a friend in the Boston area where I was running meetings at Concord Prison. I got a call from Inverness: would you come over here and introduce it into our prison?

My wife's got a Scottish background, so I said here we go — a tax-deductible trip to Scotland. We introduced the program there. Two years later they asked me to come back and go to Glasgow, Edinburgh, Aberdeen, and so forth. And when I got there, they said the governor wants to see you. I didn't know who the hell the governor was, but I figured he was running the prison. I went into his office, sat down, and he said, "Joe, I have never seen anything like this in my 20 years in the Scottish prison system." Would you like that for an unsolicited testimonial?

SHAY: Yeah.

JOE: So it changed everything in the prison. He said the corrections officers came down and told him they wanted to be trained as facilitators.

SHAY: Really?

JOE: So yeah. It's a small prison, maybe 180 prisoners from the Highlands. But obviously it had a dramatic beneficial effect there. And from there it spread to all the Scottish prisons and almost all the English prisons.

And we have a study from the Australian prison system — New South Wales, which is the state in which Sydney sits, so 4 million people. They did a study with SMART Recovery versus six other programs, a controlled study on 6,000 inmates with an addiction history, which I think is the largest controlled study ever done in a prison system. And the one result was a 41% reduction in violent crime convictions after release. Not recidivism like they didn't show up to a parole hearing or something — it's a very hard endpoint. And it was just as good in Aboriginals as in native Australians, people new to Australia, whatever — all seven demographic groups, women, men, whatever. So it's a very powerful change agent, and they're still pushing it on.

There have been seven circuit courts of appeals decisions and three state Supreme Court decisions establishing that AA and NA are religious programs — pervasively religious programs — and anybody who objects to that has to be provided a secular alternative. Now we know it's still happening, that people are being coerced into 12-step no matter whether they're atheist or agnostic or non-religious or whatever. But I think it's gradually spreading through the legal system, and judges are more careful now about who they're referring where in drug courts and so forth. But there are still some who figure ways around it.

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[SHAY interjects: Okay, so here's my problem. I didn't grow up with grandparents. I'm sitting across from this brilliant man who's from Boston — I imagine that Joe is tough as shit — but I just cannot help what my brain does. And in this upcoming moment, I experienced cuteness aggression like you wouldn't believe.

I figured in order to salvage this — because Joe is probably fuming right now hearing this — in order to salvage this, I would like to just introduce what I looked up. Cuteness aggression toward our esteemed elders is a form of dimorphic expression — have I won you back yet, Joe? — a psychological phenomenon where the brain experiences such an overwhelming rush of positive emotion that it introduces a contrary, slightly aggressive expression to bring balance. While typically associated with babies or animals — I might be losing him again — this reaction occurs when an adult perceives a senior as particularly charming. I hope I've won you back.]

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JOE: I'm gonna put this on airplane mode just a second.

SHAY: No problem.

JOE: Just a second. Okay. Airplane mode on. Hope I remember to take it off. So that gives you an outline of what's going on.

And interestingly, I have found that I have collected 245 people who had something that I call an aha moment in conjunction with SMART Recovery, or they came to SMART Recovery after they had it. But it's a very interesting phenomenon for humanists who think rational thought is the only thing that counts. These people had an experience — it's known as an aha moment. I don't know if you've ever heard that term.

SHAY: Oh yeah.

JOE: Also known as a eureka moment. After which they have no urges whatsoever. They're done with their addiction. So I've picked up 245 — I've done 4,000 meetings. And then 55 people so far have had an ecstatic experience, like a religious conversion experience. It's interesting because no real conscious starts are involved. Most of them have a predicate experience, a very negative experience, and suddenly they just say, that's it. And it's quite a remarkable phenomenon. They don't have any urges at all. They don't have an occasional thought. They just dismiss it.

I thought nobody else had ever heard of this thing. And then I realized that a very famous researcher named William Miller — the inventor of motivational interviewing, the most dramatic change in the therapeutic regimen in the last 30 or 40 years — I got his email address and I wrote him about it. And he said, I wrote a book about this called Quantum Change. Not specifically in people with addictions like I did, but in the general public. He said 123 cases. So I'm way ahead of him. But anyway, we seem to be the only two people. We're on a first name basis now. We communicate all the time. I was just a lousy assistant professor at Harvard. This guy's a professor emeritus, has got all kinds of honorary degrees and everything. But it's Bill and Joe now. We talk over this phenomenon.

So that's another thing. Just by being one of the founders of this organization — and of course, since I was an academic, I was able to weasel my way. Not that I've written a lot of articles or anything, but the prestige of being a Harvard professor led me to have relations with Dr. Nora Volkow, the head of NIDA, and with John Kelly, the professor of Addiction Medicine at Harvard, and so forth. And they were the authors of one of the papers in the New England Journal. Of course now they're very familiar with SMART Recovery. And when the time came to recommend mutual aid groups, they said SMART Recovery. They're well aware.

Matter of fact, I wrote a note to John Kelly — John F. Kelly, there are a lot of John Kellys around — a wonderful guy, a real mensch. I told him that there were two other articles in addition to his article in that stretch from January to April. He wrote back a note saying, "Thank you for starting SMART Recovery." So that was almost as good as what the Inverness governor said. He realizes the importance of having another solid option for people. He did a study with Neil Humphreys from Stanford — another big name — a dictionary search of why people leave AA. And when I read that, I invited him to come and talk to the local Boston facilitators. That's where I met him, that's where we established a relationship. And he eventually did a big study on SMART Recovery, and of course gave us the shout out in the New England Journal of Medicine, which is a big deal.

SHAY: Yeah.

JOE: That's been published every week for 213 years. So when something comes out there, it's got real weight.

SHAY: One thing that you and I have in common — I was raised Reform Jewish. I only recently identify as a Jewish humanist. Did you grow up as a humanist, or was it a —

JOE: I never believed all that Bible stuff. I think. I was bar mitzvahed because that's what you did. And I wasn't that thoughtful about it. It's just, looking at all the evil crap in the world, I didn't see where any God was at work. But that's it. And then in college I got into the philosophy and the proofs of God's existence and so forth.

And I attended a Unitarian church with my family. My wife was like a lapsed Presbyterian, but she was never confirmed. When the time came at 12 years old to be confirmed, she refused. She had a very good pastor at that time. He accepted the fact that she shouldn't be confirmed until she was ready to be confirmed and whatever her reasons were.

We joined a Unitarian church, a very liberal Unitarian church. And there were a number of agnostics and atheists in it. And we got very deeply involved. It was in our community. She was the head of the senior church committee. At one point I was the head of the junior church committee, so we were integrated into that.

And then the two ministers decided to bring communion back into the church. That was too much for me. I found there was a group called the Humanist Association of Massachusetts. I went to a meeting, I liked it, and pretty soon I was the president. And eventually we started the Humanist Chaplaincy at Harvard in 1991. It's a big deal now — it's the Humanist Chaplaincy at Harvard and MIT. They've got a wonderful chaplain and an assistant chaplain. And he just wrote a book called Tech Agnostic, which was a bestseller.

SHAY: Yeah. We interviewed Greg on the podcast. He was our first episode. Wait, okay, so can I rewind you all the way back? You're a kid, you're not buying into the Bible stuff — how did your family respond to this? Were you vocal about it or —

JOE: My grandparents were pious — but not, they would go to the synagogue on the holidays, but not otherwise. My grandfather was from Ukraine, my grandmother was from Latvia. They were traditional Jews, I would say. We had the Passover dishes and all of that stuff. And then my parents — I'd say firm cultural Jews, but they really weren't religious. And matter of fact, when I decided to marry a Presbyterian, my parents were very upset. Tried to talk me out of it.

SHAY: How old were you?

JOE: By that time I was probably 29 years old.

SHAY: Oh, okay.

JOE: Yeah. And she was like 27. So we were certainly consenting adults, and I laid down the law. I said, look, this is the woman I love and the woman I'm going to marry, and I hope you'll accommodate to it. But a year after, my mother came up to me after a Passover dinner and said, "Joe, you married a saint." So that was the end of that problem.

SHAY: I love that.

JOE: And I did.

SHAY: Joe, can I call you Joe? That's so — that's so romantic. Oh my goodness. Wow. So okay, my great grandmother was — she kept kosher, like she went traveling with her own silverware and everything. But yeah, I don't even know if you consider yourself a humanist Jew. Do you still identify culturally with that?

JOE: Yeah. Yeah. I speak a little Yiddish.

SHAY: A schtickle?

[SHAY interjects: Good job, Shay. You told the man that he speaks small Yiddish.]

JOE: A bisl Yiddish.

SHAY: A bisl Yiddish. Yeah. That's so interesting. Okay, so now we got the childhood down.

JOE: There was a speaker at the FFRF conference — I forget what his name was — and he got up and he looked around and said, "I've never seen so many humanists since my bar mitzvah."

SHAY: That is — that's —

JOE: I guess that's a common experience. Yeah.

SHAY: Yeah. My uncle was atheist, and my cousins are atheists, and all Jewish. And I was just like, wow.

JOE: Bagel and lox Jews.

SHAY: Okay. So your only connection to the addiction piece was that you were treating patients who were upset with the way that things were. Now, I've wanted to attend an Al-Anon meeting in the past — the friends and family part that you're talking about.

JOE: Yeah. They claim that it's spiritual, not religious, but it's just not true. When you go to a meeting, you will find a lot of hyper-religious Christians. We have a lot — we are in five Muslim-majority countries, okay? It's secular. Our handbook is in Farsi, in Arabic, in Indonesian, in Malaysian, okay? So this is a secular program. That's a Christian program, a Christian religious program, and seven courts have judged it to be pervasively religious. They have nothing against 12-step. They say you can't force an atheist or agnostic or non-religious person into it. Not constitutionally viable.

The last ruling from the Ninth Circuit — California, Hawaii, Oregon, Washington — said, and let me get the exact quote: this is well-accepted law. We don't want to hear any more cases about this. Seven circuit courts are enough. Now, West Virginia — I don't know what number its circuit court is — has never ruled on this. Strictly speaking, it doesn't apply in their circuit. So they had some guy who wanted a secular program in order to get parole, and they wouldn't give it to him. They said just fake it — fake it till you make it, and all this kind of stuff. And they probably got legal advice that it doesn't apply in their circuit.

When it finally, after a year and a half, got to a district federal court, they were excoriated by the judge — the district court judge — who said basically, are you people back in the 13th century? This is clearly unconstitutional to do this. That's where we stand now.

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FISH: I'm Fish Stark, Executive Director of the American Humanist Association.

AMITAI: And I'm Amitai Heller, Legal Director of the AHA's Legal Center.

FISH: Right now, religious freedoms are under attack — and that includes the ability to not believe. And when those rights are violated, we're here to fight for you.

Your boss says the only way to get promoted is by joining his Bible study group? Well, we'll walk into his office with a ten-foot Constitution and slam it down on his desk. We don't actually have a giant Constitution, but yeah, that is probably a violation of your rights.

Or your kid's coach says no pray, no play? We will show up in matching tracksuits and we will coach the team ourselves. We don't do that. What we do is we defend the rights of students in court.

And if a judge tells you to read the Bible as part of your sentence, we will storm into that courtroom with a choir singing "We Will Rock You." Still no choir. But yeah, that's probably unconstitutional, and that is exactly why we're here.

AMITAI: None of those are real numbers. Please just go to americanhumanist.org/legal and submit your case. We're here to protect your rights.

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JOE: So the words "pervasively religious" — I'd say two thirds of the people who come to SMART Recovery have been to 12-step. And it's not all about religious stuff. Some people can stomach that. Some vitriolic atheists have done well in the 12 steps. They're just able to put the blinders on and it doesn't bother them that much. There are plenty of atheists who don't care if people pray for them or whatever, or they just ignore it.

Other people are vehemently opposed to being subjected to that kind of talk and so forth. But basically there are two kinds of people in the world, and people in between. There are platonic people — spiritually oriented — and Aristotelian people — empirically oriented. And then there are people in between.

About 30% of people who come regularly to SMART Recovery and consider it their primary recovery modality also go at least occasionally to 12-step meetings. Maybe they were in it and they met people they liked and they go back to see them, or they want an in-person meeting and there's no in-person meeting in their area. Because some people want an in-person meeting — that's important to them. They don't like Zoom. Most of the younger generation is comfortable with Zoom meetings.

It's always been my intuition that there's more mutual support and mutual cohesion at an in-person meeting. And now we have evidence for that. We have a study of four different groups — AA, SMART, Life Ring, which is the surviving aspect of Secular Organizations for Sobriety, so that's a secular program too, and Women for Sobriety — and they have both Zoom meetings and in-person meetings. And the people who attended in-person meetings do better in recovery, in all four groups.

So that's true. I try to counter that by asking people to turn their cameras on so that they see the faces of people who are there. I say a black box on the screen is not supportive. Even though mentally they're supporting you, it's not their face.

SHAY: Yeah. It doesn't count.

JOE: I don't know if you know it, but we have a special place in our brain to recognize faces. I don't know if you remember Oliver Sacks' book, The Man Who Mistook His Wife for a Hat — that was about someone who had this condition, prosopagnosia. He had his wife wear a certain hat because he couldn't recognize her.

SHAY: Oh. Is that where you can't identify the —

JOE: Can't identify the human face. Yeah. You see the image — we know that from functional MRIs. The image is projected on your occipital area, the visual area, but you can't integrate it with your memory. And so we have a name for that: prosopagnosia.

SHAY: Yeah, I think Tig Notaro has that, where every time a fan or a networking actor or comedian would approach her, she would be like, I'm sorry, I'm —

JOE: Yeah. This amazing thing. And that's why I emphasize to people how important a human face is. So basically, I have one meeting that's got about a hundred people. So I get at least 25 to fill up the Zoom screen with faces, and I wait — usually they'll finally, 25 people will put it on. That was a big disappointment to me when we first started doing Zoom, three months before COVID struck. I thought everybody turned their camera on, except maybe people who were very careful about anonymity.

SHAY: Oh yeah.

JOE: Now in Australia they have a separate organization and foundation, and they've done very well. I talked a very rich guy into supporting it. I met him in Hartford, Connecticut. He came from New York to Australia, and I came from Boston. We met on a hot Sunday in Hartford, and I talked him into supporting it, starting a foundation.

When COVID struck — it's persistent and widespread in Australia — when COVID struck, they opened the mail. There was a check in there for $400,000 to put all their meetings online. They didn't even ask for it. The government realized it would be a problem and they sent them a check for $400,000.

SHAY: Is it not so nice to have a proactive, cooperative government? It must be nice.

JOE: I would like to have been there opening the mail.

SHAY: Yeah. Wow.

JOE: That's only $300,000 US.

SHAY: Oh my goodness. A lot of people will say you don't have to use God as your higher power, you just have to have a higher power of some sort. Even if it's — I was learning GOD is Group of Drunks — like whether it's the group of people around you or whatever, there —

JOE: And if you can do that, fine. But obviously some people just don't like that atmosphere, or they want an objective, empiric atmosphere. We're working with cognitive behavioral psychology, motivational interviewing, stages of change. These are all accepted tools that are helpful to people.

And so, as I say, there's 30% of people who are in the middle. It doesn't make that much difference to them. But the real Aristotelian types generally don't like it and they leave. And look, at least half the people who come to SMART Recovery describe themselves as religious. Either they didn't get anywhere with the 12 steps, or they didn't like it, or they didn't like the religious persuasion that was imposed on them. I had one Catholic guy who said, I don't go for that holding hands and saying the Lord's Prayer. He said, I go to the priest every week and confess. I don't want to talk to a bunch of strangers about my problems.

That's it. This is America. We have a Constitution, and you make a choice. You can make a choice. Now, that's all.

SHAY: Wait, so in SMART Recovery, you don't share your story in front of everyone else? How does that —

JOE: You check in to every meeting. You get about two minutes to say what your problem is, what your goal is — gives us a concept of, have you had periods of sobriety, are you taking medications to help you, and so forth. Gives us the matrix of your problem. And then about one minute on how your life's been going the last week or two — good things and bad things.

And then the facilitator — we have trained facilitators, we've trained about 12,000 of them. We have an online training that takes about eight to ten hours, and you get a certificate and you can start and run an official meeting. They provide you with a Zoom license and so forth. And then the facilitator's job, besides managing the interaction and discussion among people, is to pick a tool that might be useful from our toolbox of 16 tools and apply it to whatever comes up with this individual's problem.

SHAY: Can you give me an example of what some of the tools are?

JOE: Yeah. I invented one of them. It's called Hierarchy of Values. I have people list the values that are most important in their life — 1, 2, 3, 4, 5. This is a motivational tool.

There are four stages of recovery — well, five stages: contemplation, preparation, action, and maintenance. And then graduation is the sixth. This is a motivational tool. So people write down what's most important. Then they almost never write down anything about their addictive substance, which is amazing. That's why they're at the meeting. That's what's screwing up their whole life.

I said, okay, what does your wife think about it? Oh, she hates it. We argue all the time. How about your sisters? Ditto. How about your two grown sons? They begged me to stop. How about your health? My doctor told me my liver tests are abnormal. That's the main reason I'm here. So what about your favorite thing in the world? Trips to Italy for two weeks every summer. I canceled it because what good is a trip to Italy if you can't have a glass of wine with dinner.

SHAY: Oh wow.

JOE: So I said, what about alcohol? This came to me — this was an aha moment in the middle of a meeting. Somebody had come to five consecutive meetings and always said, I'm not sure I want to stop drinking. So I got sick of hearing that, and it jumped into my head. I stole this from Abraham Maslow, this idea of a hierarchy. I found out that Voltaire actually said it in his memoir about England. He used those exact words, "hierarchy of values." Said in England it's commercialism at the top and in France it's religion.

He said, alcohol isn't a value. I said, how about access to alcohol? He was a lawyer, so he said, no, I disagree with you. Okay. That's it. We move on. We don't argue with people. We don't tell them what to do. They tell us what they want to do and we help them if we can.

Next week, he checked in and said, I've decided to stop drinking. So I said to myself, wow, this is quite impactful. There are people who carry around the list in their shirt pocket. They get in there, they take it out, and they look at it. You may say they knew all that already. Yeah. And they didn't — they were able to ignore it. But when you see it written on the whiteboard, you can't ignore it anymore.

Now, if you do it with people who are in solid recovery and want to stop, some of them will throw in abstinence or sobriety or recovery as a value. But most people who are just coming new to a meeting, that's usually who I use it on. It stuns them, because it's written down and they can't ignore it, and it's very powerful. They may still have a long road ahead of them, but it sets the barriers very clearly.

SHAY: So that person who had written down his values but was saying that he wasn't ready to let go of drinking was just left alone with his thoughts around his —

JOE: I guess so. He came back and came for six months. As far as I know, he never took another drink. It was crystal clear that time had come.

SHAY: Yeah.

JOE: And it's like your best friend — or a relationship. You're in a relationship with a partner and it becomes clear it isn't working out, but people hang on, just because it's easier to hang on than it is to —

SHAY: Yeah. Gladys Knight said, neither one of us wants to be the first to say goodbye.

JOE: Yeah.

SHAY: Okay. So there's a lot of mention — I've been told — around the seven deadly sins in AA. I don't want to imply that SMART Recovery is just a secular translation of AA, but —

JOE: We're not big into making amends and all of that stuff. We're oriented to the future. What are you gonna do? The Henry James novel ends, it says: living well is the best revenge. You don't have to go tell people, I'm terribly sorry, I got drunk and I hit you or something. Stop drinking, stop drugging, and straighten out your life. And if that person is interested in reconciling with you, they'll show up.

One woman said — she knew the AA thing — and she said at a meeting, I don't know whether I should call and try to reconcile with the people who told me I'm done with you. I said, it's highly up to you, but write them a note if you want. Say: I haven't had a drink for a year, I'm never going to drink again, I know I disappointed you many times. If you're interested, I'd like to get together again. And if they believe you and they want to give you another chance, they'll get in touch with you. And that's it. Other than that, don't bother them. Maybe they don't want anything to do with you.

SHAY: That's — I'm so glad that's a part of it, because for a very long time, outside of recovery, it's been a real frightening thought to think that anybody that I had cut out of my life would try to approach me to make amends. I'm like, please don't. It can be very harmful and traumatizing for the person that has finally moved on.

JOE: Yeah. But anyway, it's up to the individual. We don't tell people what to do, but we try to give them options. Say, here are a couple of different options. Figure out if one of them might be helpful to you.

But basically, cognitive behavioral psychology is a forward-looking therapy. What are you gonna do now? That's how normal people work. Abraham Maslow was the first person to discover there was something called normality — not average. This is different. 10% of people are normal, and of course 50% of people are median or average. I didn't understand that, even though I read his book Normality when I was practicing medicine. And I ran into some people who just seemed like they were in denial, but they weren't. They were normal.

I took care of them for 30 years. Some people — they were perfectly normal, wonderful people. They just, you tell someone, your biopsy came back, you have cancer. And they say, well, what do we do now? What are the options? I'm thinking, maybe this person didn't hear me. Most people say, what did I do to deserve this? And they cry and all this stuff. I saw there was something wrong with this person. I found there was nothing wrong with them at all. They did it perfectly normally. They recognized the negative aspects of making decisions while emotionally distressed, which is the core of cognitive behavioral psychology.

And it was rediscovered from the Stoics by Benedict Spinoza, who said — I call it slavery when, because of the passions, meaning intense emotions, people know what is best for them but choose to do the worst. Which is what an addiction is.

SHAY: Yeah.

JOE: They know what's best, but they choose to do the worst. Why? Because they get emotionally upset — depressed, anxious, or angry — and punch people and do things like that. Or go to the liquor store.

SHAY: Wow.

JOE: Typical of people with an addiction, right? Maybe they've been sober for three or four months, and then their rent is raised or whatever the hell it is. They get upset. First thing that comes into their head: I need a drink.

SHAY: Yeah.

JOE: Let me tell you one more story because it involves a Catholic, okay? Listen.

SHAY: Always here for a Catholic story.

JOE: Irish Catholic particularly. I met him in the emergency room. He was diabetic and he had an infection on his toes, which is a very serious issue in a diabetic. So what we do is we circle the redness around the infection with an indelible pen, we put the person on oral antibiotics, and we see them the next day. And if that redness is shrinking, we keep them on oral antibiotics. If it's enlarging or the same, we bring them into the hospital and put them on IV antibiotics.

This gentleman came in to me the next morning, and I was walking down. I had squeezed him in — I figured five minutes just to make the decision. His wife stops me in the corridor and says, can I talk to you? Like always, a bad sign. The day is gone. Okay.

So she says, I just want you to know that my husband has a terrible alcohol problem. He works for Raytheon. He has a wonderful job. He's had two warnings. They say if it happens again, you are done. And he's two years from being vested in his pension. I've had it with him. I gave $500 to a lawyer yesterday for a retainer for a divorce. Now this is a big deal. This is 1980, 1982 maybe, in Massachusetts, when a divorce for a woman — that's it. You're done. No annulments or anything like that.

I went in the room, I looked at his foot, and it looked good. And I said, Joe, your wife tells me you have a bit of an alcohol problem. He says, oh yeah, I'm in big trouble at work and this and the other. I said, would you like me to recommend what kind of help you can get? He said, oh yeah, please do.

I told him about AA — he shouldn't even know about it anyway. And I said, but would you like to go to a meeting? He said, okay. I said, do you want to go here in Watertown or do you want to go to a different town? He said, I want to go to a different town. So I went on the phone and I got him a meeting in Wellesley or something. And I said, I want to see you again tomorrow.

So he came in the next morning and I said, how was that? He said, not for me, doc. Not for me. I said, what's the matter, what's the problem? He said, I don't go for all that touchy-feely stuff. Hugging and holding hands. That's not for me. I said, I'll get you a different meeting. I want to see you tomorrow.

Didn't want to go back. What's wrong? He said, I confess to my priest every week. I don't want to confess and talk over my problems with a bunch of strangers. I mentioned him already. So I said, look, this is a life and death situation for you almost, and blah blah blah. So he tries it again. Then he comes back and says, that's it. I'm done. I'm not going anymore. I just don't like it.

So I said, I'll refer you to a psychiatrist. He said, I'm not going to any psychiatrist. I'm not crazy. We had a long discussion about you don't have to be crazy and this and that. He absolutely refused.

So I said, let me make some inquiries, I'll get back to you. I talked to a family social worker, a family counselor, and he said, well, send him to the DUI program. I said, he didn't have any DUI. He said, that's the only other thing you can do. Meets every Tuesday and Thursday at your hospital. So I called him up and I referred him to this group. I said, I want to see you the next day.

He came in with a notebook — he was a quality control engineer at Raytheon. And I said, how was this? He said, oh, great. I said, what? They explained everything to you about how alcohol affects the liver and the brain and so forth. And he started asking me questions, things he'd written down that he wanted explained.

I said, you're going to go back? Oh yeah.

He went to the DUI program, never had another drink.

SHAY: Wow.

JOE: Six or seven years go by. Now this is before I ever heard of SMART Recovery. There's no SMART Recovery, no Rational Recovery, nothing. I said to him, Joe, do you ever have an urge to drink? He said, no. I said, you're Irish. You go to an Irish wedding. The liquor is flowing like water. What do you do? He said, round of for everybody, I'll have a Coke.

I said, oh, wow. That's terrific. He said, however, my son-in-law, who's an alcoholic and who's going to AA — he said to me, you weren't addicted to alcohol, because when they tell them that AA is the only way to get over alcoholism, and somebody gets over it — the defense is: you weren't a real alcoholic. In other words, you hadn't sunk low enough.

And he said, oh yeah? He calls over his wife. He says, you tell him if I was a real alcoholic. And she says, oh, I used to come in at night and he'd be unconscious in the foyer. I had to step over him, and I was going to divorce him, and he was going to lose his job. He said, no, you weren't a real alcoholic.

Okay. So this is the brainwashing that goes on, and the cultic aspect of AA. Now, that doesn't happen at every meeting. But I followed him for 17 years because he had diabetes and hypertension. I saw him at least once a month. We were great pals. And he'd retired. He came in to say goodbye. Said, we're moving up. I have a home in Lake Winnipesaukee, and we're moving up to retire.

Of course, that was in the back of my mind when I heard about Rational Recovery. I remembered this incident, and I understood what was going on. He was just an Aristotelian person and he didn't want anything to do with the Platonic program. That's all.

Now, have you ever been in the Vatican?

SHAY: No.

JOE: Ever visited the Vatican. So if you go to the Vatican, they take you across the Sistine Chapel. Another place they take you — if you're ever in Italy, take the tour. It's unbelievable. They take you to the library, they've got the most magnificent stuff you can imagine. The treasury, all that.

If you go in the Pope's audience room — big room with his throne sitting on a dais — there are three paintings on the wall, one behind and one on each side. Huge paintings by Raphael. It's called School of Athens. And it shows these three paintings like a Cinemascope — beautiful gardens and paths and temples. They're three separate paintings, but they're close together so it looks like a landscape.

In the central one, that stands right behind the Pope's throne, is a temple — a big Greek temple like the Parthenon — and a few people sitting on the steps and whatnot. And in the middle stand two figures: Plato and Aristotle. Now, they weren't contemporaries, so there's an anachronism. Each has a huge leather-bound book under his left arm. Plato is pointing like this, and Aristotle is pointing like this. Plato's pointing up. Aristotle's pointing down.

So that's it. Raphael and the Stoics and the great philosophers understood this very well. Different folks, different strokes, that's all. And then in the middle are people who don't have a bias in either direction.

So that's what we have. We have an Aristotelian program and a Platonic program. And these canvases are 15 by 27 feet. What would the Pope put in his throne room?

SHAY: Oh yeah.

JOE: Artist of the century. But I don't know if he really recognized the implications of it. Of course, you know what happened to Galileo? He was this kind of a guy. When the Reformation came and the Pope moved over to this side, he was done. They were done with him. He spent 15 years trying to elude the Inquisition. Trying to be an Aristotelian in a Platonic phenomenon — the Catholic Church. And they finally caught up with him. They said, cut it out. We're done with Aristotle. But that great painting is behind the Pope's throne.

SHAY: As if I didn't want to go to Italy badly enough. Now I have —

JOE: You get the chance, check on it and get back to me.

SHAY: You ever get the chance.

JOE: Oh, I will. It's gonna happen.

This guy I was telling you about — he went every year for two weeks. He loved it. He loved it. But he stopped going because he wouldn't be able to have a glass of wine. If he could have had a glass of wine with dinner, he wouldn't be in a recovery group. The problem was he couldn't have a glass of wine without having a bottle of wine. So eventually he figured that out.

SHAY: So are you retired now?

JOE: I've been retired since 2001. I had a 40-year career in medicine. But I've done 4,000 meetings. I run two meetings a week right now. One is in Miami Beach — although it's on Zoom, it gets about 40 people. And the other one gets 90 to a hundred people every week.

And then I do two meetings in sober homes in Baraboo, Wisconsin, because we have a grant from Elance Healthcare to do one of our programs in a hundred sober homes. Not SMART meetings, but a didactic program about SMART Recovery. We're just finishing it up now, running to a deadline, so I said I'll do two meetings a week so we can get to the deadline and finish them up before the end of the grant.

SHAY: What do you do outside of this? What are your hobbies, Joe?

JOE: I play tennis, I read books, and I garden.

SHAY: Oh, you're a gardener. Green thumb. Nice.

JOE: Yeah. I had to learn tropical gardening. My mangoes are now — the aroma's fantastic.

SHAY: Oh, mangoes.

JOE: Yeah.

SHAY: Okay. If I come to visit — because I do, I really do want to petition for you to adopt me as your grandkid. But anyway, throwing that out there. Thank you so much, Joe. Appreciate it. Wonderful meeting you.