Somatic Embodiment
Everyone has heard of Alcoholics Anonymous (AA). The group creates meetings that provide a safe place for problem drinkers to share what they’re going through as they attempt to recover. Attendees receive social support and insights from others who are struggling with the same problem. It is a lifeline for many.
Less known is the term “12-step program” or simply “12-step.” AA is probably the best known 12-step. Others you might have heard of include Narcotics Anonymous, Gamblers Anonymous, Sex Addicts Anonymous, and Marijuana Anonymous.
There are also 12-steps that are catered not to the problem user him- or herself, but to those in the periphery of the problem who suffer in their own ways. Al-Anon, for example, aims to support the family and friends of the one pursuing the problem behaviour. Alateen supports teens who have a problem user in their lives. In these cases, a main focus is on the risk of co-dependency, which might involve behaviors that are unhelpful to and even enabling of a friend or family member’s problem.
The 12 steps were introduced in the 1930s by Bill Watson in a book called Alcoholics Anonymous: The Story of How Many Thousands of Men and Women Have Recovered from Alcoholism, now known casually as “The Big Book.” Generally, the 12 steps look something like this:
1. Admitted powerlessness in the face of the problem behavior
2. Acceptance of a higher power (often but not always God)
3. Turning over one’s life significantly to this greater power
4. Acknowledgment and acceptance of mistakes made during periods of pursuing the problem behaviour
5. Admitting such mistakes to the higher power and to another person
6. Willingness to allow the higher power to remove the character flaws that allow for these transgressions
7. Asking humbly for the higher power to remove such character flaws
8. Listing those who were harmed by such transgressions with the intent to make amends
9. Making amends to such people, unless this would harm them
10. Continuing to account for and amend transgressions
11. Prayer to continue and further the connection with the higher power
12. Spiritual awakening, which is shared with others struggling with the same problem
Health professionals often recommend a 12-step for compulsive and addictive behaviours, in addition to other forms of treatment (e.g., a rehab program, seeing a counsellor or psychotherapist, and/or meeting with a physician). Yet there has been extensive controversy about the efficacy of 12-step programs. AA, in particular, has been accused of inflating its success rates. Among the skeptical community, a statistic that is widely cited is that AA has merely a 5 to 10 percent success rate.
The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry, encapsulates the problem: “We hear from the people who do well; we don’t hear from the people who don’t do well.” This is disconcerting given that many in such programs are not even there of their own volition. Rather, they might be in such a program because of a court order, for example, or the prescription of a physician.
The idea that the12 steps should work for everyone is unrealistic, especially when the edifice wasn’t built scientifically. Further disconcerting is that the 90 percent who don’t succeed might be thought of as having failed to properly follow the program. It failed because they failed. This won’t do.
On the other side of the debate, however, are medical and mental health professionals in the addictions field who have worked with thousands of patients struggling with compulsive and addictive behaviours. Professionals have seen firsthand, over and over, how 12-step programs like AA can help guide a person though the process of identifying and letting go of a problem behavior. Lives have been saved.
What is it that works for many, but not for so many others? It’s likely different for everyone. One aspect everyone can enjoy, however, is the social support of a community. And if attendees stick around long enough to become mentors about the journey, they become sponsors for newer members and add service and altruism to their own recovery. This relationship with a sponsor can be the most profound aspect of recovery.
One common challenge that can get in the way of many people attending a 12-step is the admission of powerlessness in the first step. It might seem to some that powerlessness suggests an inability to fight the problem. Another challenge is the encouragement to accept God or a higher power, which might alienate non-religious types. This feature might make it seem that AA and other 12-steps are too largely a religious process. AA, in particular, has been called a cult, by many who’ve attempted it and left.
There’s a hack for the religiosity of many 12-steps. The concept of God or the higher power effectively can be a placeholder. In that spot, we can replace the God-like higher power with the power of the condition you are struggling with. Where the religious person puts his or her faith in the higher power and healing process, the secular person can instead put his or her trust in the condition and healing process.
And there are secular 12-step alternatives. Rational Recovery is an approach initially based on the 12-step model. Another secular program is Self-Management and Recovery Training (SMART) Recovery, which eschews not only the higher power, but also the concept of addiction as a disease. Such problem behaviors are seen instead as unhealthy habits.
Twelve-step programs offer people struggling with addiction the supportive community that they often can’t get anywhere else. The programs will never be flawless, but we should never assume that 12-steps are useless and that they can’t be improved. We should keep up the skepticism, the criticism, and the tweaking. But also remember that the meets — both group and with your sponsor — are free. And they’re widely available at many times of the day, all week.
It might be that 12-steps help only 5 to 10 percent of the people who start. The numbers 5 and 10 might seem low, certainly lower than we would like. But 5 and 10 are better — infinitely better, in fact! — than zero.
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