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What about attending 12 Step Programs?

When it comes to problems with alcohol or substance use, it is common to assume the knee-jerk reaction in the treatment community is to send people to AA or NA when their treatment is completed. Even the judicial system has done more of the same when someone gets a DUI, “Order them to AA.” 

 Let me chime in from a clinician’s perspective:

Alcoholics Anonymous has been around since 1936. And to date it is still used in helping people stay clean and sober. It clearly has not been the cure-all for all addiction ills; however, AA and the other 12-Step programs have proven to be rather successful helping people stay clean and sober, especially when the person is willing to go to whatever lengths to remain abstinent from their drug of choice. (I will speak more later about the willingness to go to any lengths). What has often been difficult for me in my profession, is encountering a client who has had an unpleasant experience with AA and wants nothing to do with it. Often, I get a client who will say they hate AA, and it does not work. It does not help that there are websites like the Orange Papers that go to enormous lengths to convince people that AA is a cult, the website goes on to say, “The goal of 12-Step-based ‘treatment’ is not to heal people and end the treatment; it is to addict the patient to the treatment, to make him psychologically dependent upon A.A., so he/she will spend the rest of his life in a 12-Step group like Alcoholics Anonymous or Narcotics Anonymous”. Wow, that sounds scary. Fortunately, it's not true.

I’m not trying to be a cheerleader for AA and thankfully, they would never allow that. However, it seems that many in my field of substance use disorders put a distrustful and hateful spin on AA. Some clinicians call AA the worst thing that was ever created. Really? I am not sure how one can come to that conclusion unless they were accosted by some alleged AA bullies (I don’t think there are any) and teased profusely for being a teetotaler.  I’m just kidding about the teetotaler part. I have witnessed thousands of lives saved and made better by those who have chosen to engage the 12 Step recovery programs. I have also encountered others where it just didn’t work for them and they have been able to function well (Be careful with that last sentence, it did NOT mean that happens a lot of the time).

In this article, I hope to answer or at least discuss some of the concerns and criticisms about 12 Step programs.

I have conducted thousands of assessments and intake interviews on individuals needing help with substance abuse, misuse, and dependence problems. During those sessions, I often ask what was done in prior attempts to quitting using drugs or drinking. Of course, the subject of 12 step programs come up because it is useful to find out how working with other recovering people and attending meetings panned out. Some say they went to a meeting and thought it sucked, hence never went back. Others noted that the groups were too religious for them, and disliked God being shoved down their throats. Some stated the meetings seemed cult-like to them or it was just too "pooky-pooky”. I have heard on several occasions the meetings were extremely negative and the members wallowed about how horrible life is without drinking. There have been some who mentioned that after attending a meeting, they went straight to a liquor store and bought a bunch of booze. And the last one I’ll mention is the person who got a sponsor where that relationship went sour, thus, never to return to meetings. I am not saying any of the abovementioned is a bunch of hooey, lame, or false. What I am saying is if these experiences have occurred, it could prevent a person from being willing to give 12 step meetings another shot and allow the meetings to be an essential part of their recovery process.

Note, I have also worked with many who did go to AA meetings in the past, however, because they relapsed, they felt ashamed of returning fearing they would be ridiculed or shamed for not doing it perfectly. Thinking they would be judged harshly also has prevented their return.

I usually provide helpful tips for people starting the recovery process and those returning, to help navigate around meetings and to maximize their benefit, which I will explain later.

I understand not everyone is going to fit in or feel comfortable with attending 12 step meetings.  I have worked with many clients who have done exceptionally well without 12 Step meetings yet willing to explore making connections. For some, that is really key in their recovery process, to make connections and create the sense of “identification” which I believe stacks the odds toward a successful recovery.

Anyway, let us look at some of the frequent questions and/or criticisms I have heard over the years and give you my take:

AA is a cult?

No. It’s a fellowship of people sharing their experience, strength, and hope. Now if you Google “what is wrong with AA?” there will be a plethora of articles (ie. The Orange Papers or writings from Stanton Peele) trying to convince you that AA is a cult and/or worse. Yes, AA is not a perfect fellowship. It has its difficulties reaching out to the problem drinker and was never meant to be the cure-all for everyone. However, this criticism of drinking the "AA Kool-Aid" and becoming an automaton (robot) will happen to you and you will be trapped in their conspiracy is a bunch of crap. You ask, “What Conspiracy?” Well, somehow that dollar you put in the AA basket that pays for rent, coffee, and literature is also supposed to be making somebody millions. Or you will be hopelessly addicted to going to AA meetings forever and therefore lining somebody’s pockets.  No, there is no AA conspiracy. 

Do I have to belong to AA forever?

No. That notion seems to come from conspiracy sites. Yes, you will see people with 20, 30, and 40 years of recovery and they enjoy sharing their experience, strength, and hope with others. That willingness to “give it away in order to keep it” is part of their spiritual fitness and recovery process. Spiritual fitness is a vital component to their recovery process. Over the years, a recovering person begins to recognize what works for their long-term recovery.  For example, I work out at the gym, run and swim 4-6 times a week. That is what I do for my physical fitness. It would be ridiculous to say “You know? I’m done, I don’t need this anymore.” Hence, if an AA member wants to keep attending meetings for their personal recovery, that’s fine. If they want to seek other means to enrich their spiritual connections, or enhance their mindfulness skills that’s fine too. And can that freak out a few fellow AA members thinking their friend is doomed to fail and relapse? Well, there have been some experiences where that has happened too.

If you don’t work the 12 steps, you will die!

Okay, I actually heard this from an old timer who had been in AA for a long time, like some time before the earth cooled (40 something years). Let's be clear, AA is not a program and never claimed it was (Even though many of us say it). It is a “society of men and women sharing their experience strength, and hope.”  Hence, after few years of winging it (1939), the early members of AA came up with 12 Steps that seemed to suggest, “This is how we did it.” Those steps were actually taken from the religious Oxford Group’s 6 Steps. Those steps were rather rigid, and many alcoholics could not adhere to such demands, let alone deal with the religiosity.  So, the steps are seen as suggestions or guidelines. I see nothing in the 12 steps that would be fatal to the recovering person who doesn’t practice the steps. However, if you want to stack the odds in your favor of long-term recovery, the 12 Steps would certainly help in that area, if you are willing to fully give it a shot.

Do I have to have a sponsor?

No. Yet, let me switch the question a bit, “would it helpful to have a problem-solving relationship in your recovery?” I sometimes offend my clients when I say, “you alone are in bad company.” A sponsor is not a therapist, not a lawyer, definitely not a doctor, and not a banker. A sponsor is someone who has worked on the 12 Steps in their recovery and is willing to share their experience and guide you through each step. Of course, finding the right sponsor can be tricky and you should ask for help in this area. You want to establish a good fit; someone you feel comfortable with. Some people stop working with a sponsor after several years yet stay connected with recovering people. Some people with over 20 and 30 years still work with a sponsor just to keep their recovery process fresh, and they know enough about themselves to prevent their dope fiend mentality from taking advantage of them. If you are not sure, get a therapist who is knowledgeable about the recovery process. 

But what if I just don’t want to go to meetings?

Well, my knee-jerk reaction is DON’T! There are no absolutes here. And like the previous question, it is more important to make a connection with a problem-solving relationship. A group process of any sort will be better than doing the recovery process alone. So, buying a box set of recovery CD’s is not going to replace the process of establishing positive connections toward recovery.  I have worked with clients who told me they do not like going to meetings yet continue to attend so they do not forget where they came from. Some say they have a built-in ‘Forgetter’ that suppresses how bad their addiction became. One client told me he doesn’t like going to the gym 3 to 5 times a week, but he appreciates himself upon leaving the gym for the excellent work he did. He went on to state, “AA is like my spiritual fitness gym, I don’t always like going, but I appreciate the lift it gives me.” Another client told me, “AA is like eating kale, it sometimes sucks, but it's good for you.” And lest not forget folks who have a history of trauma. For them, engaging with a therapist or a group conducted by a professional would be a great start.

Do I have to hit bottom before attending AA?

You will hear a person has to hit bottom (all time low) before they are ready to do something about their addiction. Yes, there are many stories of people having to lose everything to finally get that moment of clarity that drinking and using is no longer working for them. However, in order to attend an AA meeting, there is no requirement of needing an extreme bottom like several DUI’s and ending up homeless to qualify. The only requirement for AA/NA is a desire not to drink or use. So, if you attend a meeting and you don’t want to drink that day, YOU ARE IN THE CLUB! Therefore, folks who are not sure if they would fit in a fellowship of AA can come to as many meetings as they want until they have a better understanding if AA/NA would be helpful for them.

Isn’t the 12 Steps outdated?

That has been a fair argument. Why is the recovering community using 80-year-old material to help people recover from alcohol problems? I believe this is where some the Nay-Sayers get their fuel. The original AA literature is not at all easy to change (first 164 pages). So, the best the fellowship can do is produce literature of more up to date experiences such as in pamphlets and articles. AA has a monthly magazine called the Grapevine where current members share their experience, strength, and hope. Today, the Treatment Community does not always rely on 12 Step literature for treating their clients.  Most facilities will use Cognitive Behavioral Therapy (CBT), Motivational Interviewing (MI), and Dialectical Behavioral Training (DBT), Sensory Motor Psychotherapy, along with a bunch of education on Disease and Recovery.

What about newcomers not being able to have a relationship?

There was an episode of 48 Hours several years ago about a guy on probation living in a Halfway House ordered to attend AA. He met a young lady at the meetings, and they got romantically involved. Both were new in the program. The guy murdered the girl. Thus, the episode tried to highlight that there are predators in the rooms of AA. An incredibly sad situation indeed. I do know that the recovering community frowns on anyone getting romantically involved in the first year of recovery. That is because the relationship becomes the new addiction and there is hardly any sincerity in true love at that point. When you are newly sober, the LAST thing you need is a relationship. Why? Because you would Not know what one is, even if it bit you in the butt! Many people are annoyed by older members of AA saying this. They will argue that their Sponsor is controlling them. I have seen many people relapse over this. I also had a client that could not prioritize his recovery after an early relationship that should have never happened. And in his frustration with multiple relapses, he died during an overdose.

The few meetings I attended were negative!

Because AA is a grassroots society, the guarantee that each meeting will be uplifting, and inspiring is a crapshoot at best.  I tell my clients to attend meetings that make you laugh. Really? YES! Laughter is an important function of identifying with others. Comedians are successful when they use real life situations where we can identify and, in the process, we laugh our butts off (See History of Comedy on CNN)I also say, “look for the similarities in other stories versus the differences.” As a Fault Finder, you’ll always find a defect in others thus fortifying why you can’t relate. I remember a sponsor telling me, "When you attend a meeting, take what you like and leave the rest behind." In therapy, I always teach my clients to become “Solutioned-Focused” not Problem Saturated. The recovering community does the same when they say, “focus on the solution, not the disease.”