Twelve Steps Guide by Brian Lynch M.D
The reader should be warned that this piece takes a new look at the traditional "12 Steops." But first, I often find it surprising how many people still are not familiar with the movement and have not even heard of the “12 steps.” For those that are new to the the recovery process this may well be an easier read as I write this to challange much of the traditional view.
I had not reread the original version of the “12 Steps” for some time. I had occasion to do so and I was surprised at how much I did not like them. I originally rewrote them some 13 years ago and they became the basis for my book “Knowing Your Emotions.”
The format of the "12 Steps" has been used for many purposes from fixing your computer to losing weight. Here I address what I see as deeply flawed presumptions concerning the needs of not only drinker’s but addicts in general.
Many might be puzzled about this attack if they think the “movement” has great success. The fact is this is in great question. There is evidence that it is not a success overall and I would argue that the success it has is certainly not because of humiliating members in the way mentioned here but by the interest shown in the fellowship.
Finally this is not an attack on “God” or religion. As the movement itself acknowledges more diversity it has opened the concept up, long ago, of “high power” to personal interpretation but I also challenge that. So, in the end I leaving religion aside.
Accept the things we cannot change.
It is suggested that we “Accept the things we cannot change, change the things we can and find, somewhere in that wisdom a way to know the difference between the two.” That is a paraphrase.
It orients only as life and death do hang in the details, in millimeters and answers are often in short supply. We have general outlines but are often short on specifics.
At least we are in a conversation and we can always say we are trying and doing better than we were no matter how miserable that is.
I claim we are not doina all that well under the present system, We are nowhere near having the knowledge of these matters in hand as we think we might- that is where these lines fall between what can and cannot be changed.
What I call for is a radical involvement of community if real change is going to take place in individuals.
It is more than obvious that when people have had their troubles that it has been taken for granted that it is their doing. In fact, they have, throughout history been marked as “bad” and “evil.” The family is cursed with its “bad seed” and, of course, we are all “sinners.” It is up to each of us as individuals to atone for our deeds through prayer, penance and other forms of sacrifice. The idea that we might not be “responsible” for our actions is quite new and the fact that we might be able to be helped to change the way we act and do things is very, very new.
So for example the “12 Step” movement of Alcoholic Anonymous asks us to admit we are powerless over alcohol and that we are “defective.” And it asks us to go into the community and “make amends” to those we have harmed.
To be sure most of what “The Steps” and their sprit is about was wonderful and needed at the time. It got people thinking and looking in the direction of community and connection. But the more I think about them the more I see them as the merest of beginnings as they :
put the entire burden on the individual
they recognize nothing of the community of which the person is a part and that communities role in the persons dilemma.
These two statements will upset many people. They will roll their eyes and simply insist that everyone is “responsible” for their own drug use. Yet this simply is not true. Humans are social and political animals. We are not made to live alone.
A favorite reference of mine is Malcom Gladwells “Outliers,” his best seller that starts with the chapter “Rosetto” about a town in Pennsylvania where people are very healthy despite very poor health habits. They had low cardiovascular diease, cancer and no alcoholism. The only thing you could point to is a tremendously strong community life; for example 20 social services organizations for a town of 2,500.
Drug takers and drinkers do not pop up readymade
Drug takers and drinkers do not pop up readymade they are traumatized, one way or another, and this trauma is repeated over and over again AND the means to medicate it is in a milieu that allows for self-medication is extant.
Plainly speaking, people are hurt by other people. No matter who you are you take care of that hurt in some way. If you have been very well cared for most of your life, valued and have learned a sense of self, then through most hard times you will probably do well with no more than maybe a temper now and then. But I would say even few of us are that lucky.
What has been fascinating to me, over the last few years, is how clearly it seems to we all have our “poison” when it comes to self medicating. We are, as a society, becoming more open, honest and accepting of the fact that one poison is equal to another but we re not there yet. What am I saying? I am saying that food can easily be as bad as heroin depending on how much you eat. In fact it can be worse. Gambling is bad but do we recognize how many ways we gamble? Do we really recognize that the stock market, in a major way, is nothing more than gambling? The trouble with any investment is that, for the most part, it is truly unpredictable. Anything can go south tomorrow and then we are broke. The admonition is to have this well in mind when investing and not live in a delusion. This is hard to do. But still, of course, there are hundreds of ways to become “addicted” on a daily basis to trading.
In short people do all kinds of things to medicate themselves.
Now where is, again, this pain coming from? The pain we are medicating. And, again, it is comming from others and this is the problem with part of treatment or at least “the movement” and that is it does not recognize or give voice to the harm done to the individuals. Here there is no denying that there may have been done and maybe the majority of the time there is harm done by the user but the problem is where it all begins and where does it all end?
The general refain is "Don't live in the past." "Get over it it." What we now know is that neither is easy to do.
I deal with the concepts of shame and humiliation
I deal with the concepts of shame and humiliation. What starts the whole process in the first place is shame and humiliation.
By shame I “only” mean a feeling of unattained desire. This can be a wished for returned greeting form a friend or a profound sense of humiliation from a dressing down at work (the desire in retrospect of wanting to be appreciated). I “want” something and do not get it. Or I have lost a previous state of joy.
What we feel about these ideas is that these ideas about shame and humiliation are so under-appreciated that they almost go universally unnoticed/missed in our assessments. To be sure they, if considered, challenge everyone.
They ask us to consider the world from the drug user’s point of view.
From that point of view it can be said that many might claim feelings of massive shame and humiliation throughout their lives.
And so pausing a beat I ask us to consider that we are profoundly emotional beings and that unless we understand our emotions we are very often powerless over our own actions and are powerless over the world.
Yes, that is the extent of our “higher power.” We have the traditional formulations embodied in the “12 steps” but I do say that given their succinctness and emphasis on the individual it may be time to move on. I believe we end up “over explaining” them. I say the “higher power” can be, and often is, a tautology. What I call the “hot potato” answer. What is that? The analogy is to anger management. We tell people that have problems with their anger that they need to go to anger management class and manage their anger. Well this is like having someone already holding a hot potato and telling them to “ok” continue to hold the hot potato. “Ok, buddy you’re doing pretty good, let’s see what else you can do with the sucker!” Wherever you turn you end up looking at yourself. We need help understanding the purpose and origin of anger and thus emotion in general.
What has become clear to many is that anger is really not the issue at all. Anger is a consequence of a deeper hurt and confusion, if you will, shame. What has happened is that the person has “wanted” something for probably a long time and has not gotten it. Often the “want” or desire has been quite reasonable. You may doubt this. First, think about yourself. But I will give you an example. I use to work in nursing homes. Residents would want passes to go outside. So they would want and want. And often would not get the pass. I believe, often, unjustly, but justly or not, they would build up enormous hurt, confusion and/ shame and finally they would get angry. They would be blamed for their anger. Sometimes they would get violent. At the time I was doing group therapy. I suppose, I was expected to scold them. I didn’t. Many times what I saw was that their dose of Depakote would go up; a potent sedative.
We need to understand that it is a system that involves a community.
We need to understand that it is a system that involves a community or at least a dyad more than one person. We need to interact. We need to complete the “I want.”
So I believe the “higher power”, for the most part, is a neat sleight of hand for all of us to avoid this thought, the need to engage one another again throwing it back in face of individual. What I hear between the lines is “you are weak,” “It certainly is your fault,” “You are to blame” and above all it sends a message loud and clear of abandonment. “Be very clear about this buddy you are very alone at least around here.” You need to stand on your own two feet and take responsibility.
So we tell people that need connection to look to a “higher power.” Don’t ask me for help!
All this said, I am not going to throw the baby out with the bath water. The movement has come to accept a broad interpretation for the “higher power” and so I am saying nothing new and would be wrong to speak for anyone who says they benefit from using the concept. The hope is that we transition from being victim to a more self-conscious healing adult.
I must, too, not act blind and dumb in terms of the aspects of the movement that entail the meetings, sometimes daily meetings if a person so chooses, and the fellowship that entails the tradition of a sponsor that is available 24/7. If that is not a “dyad?” What is? But there is structure and there is philosophy. So often the philosophy dominates
Note, I did not say fully healthy and fully conscious adult as this is not possible. Psychology at least is telling us that we are at the mercy of our affective or emotional system and always will be. Our emotions guide us. They tell us what is important. So our early experiences inform us and they inform subconsciously and automatically for well or ill and if for ill it will take a lot of work to correct those “habits.” And we will never completely get ahead of the task, sorry to say. Right there is enough of a “higher power” for me. What is that? The cold hard fact that I just gave: the realization and acceptance that I am, as-we-all-are, works-in-progress and it takes our full attention to stay as much on course as possible and it takes at least a community of two. And that never am I saying is cannot be or could not be a “sponsor.”
Above all we are not “defective” or morally bad.
Above all we are not “defective” or morally bad. No more than anyone else.
To be sure, on this strange road, once on it I may have done many unsavory things. No question about it. The radical science or rather the true science is about not having much or any free will form where we started as children wanting to be loved. Yes people not wanting to grow up to be drunks or addicts to people being damaged and then in disassociated states that then do unsavory things.
How am I not to feel, deep inside, but more shame and humiliation if it is suggested that I am to look to myself, only to myself, for the answer? That it is essentially my job and my job alone? That I am defective? That is what the words say, “My defects.”
I turn inward then to understand the “higher power” and by that “all” I mean- and that is a lot- it is I mean that I am not in control simply through my “ego” or my reason. If I am going to have any hope of getting through life with any modicum of joy I better learn something about synchronizing reason and emotion. This will only come through some study and self-exploration but also through some community.