A twelve-step program is a set of guiding principles outlining a course of action for recovery from addiction, compulsion, or other behavioral problems. Originally proposed by Alcoholics Anonymous (AA) as a method of recovery from alcoholism, the Twelve Steps were first published in the book, Alcoholics Anonymous: The Story of How More Than One Hundred Men Have Recovered From Alcoholism in 1939. The method was then adapted and became the foundation of other twelve-step programs such as Narcotics Anonymous, Overeaters Anonymous, Co-Dependents Anonymous and Debtors Anonymous. As summarized by the American Psychological Association, the process involves the following:
- admitting that one cannot control one's addiction or compulsion;
- recognizing a greater power that can give strength;
- examining past errors with the help of a sponsor (experienced member);
- making amends for these errors;
- learning to live a new life with a new code of behavior;
- helping others that suffer from the same addictions or compulsions.
Overview
Twelve-step methods have been adopted to address a wide range of substance abuse and dependency problems. Over 200 self-help organizations–often known as fellowships–with a worldwide membership of millions, now employ twelve-step principles for recovery. Narcotics Anonymous was formed by addicts who did not relate to the specifics of alcohol dependency. Similar demographic preferences related to the addicts' drug of choice has led to the creation of Cocaine Anonymous, Crystal Meth Anonymous and Marijuana Anonymous. Behavioral issues such as compulsion for, and/or addiction to, gambling, food, sex, hoarding, debting and work are addressed in fellowships such as Gamblers Anonymous, Overeaters Anonymous, Sexual Compulsives Anonymous, Clutterers Anonymous, Debtors Anonymous and Workaholics Anonymous. Auxiliary groups such as Al-Anon and Nar-Anon, for friends and family members of alcoholics and addicts, respectively, are part of a response to treating addiction as a disease that is enabled by family systems.
History
For more details on this topic, see History of Alcoholics Anonymous.Alcoholics Anonymous (AA), the first twelve-step fellowship, was founded in 1935 by Bill Wilson and Dr. Bob Smith, known to AA members as "Bill W." and "Dr. Bob", in Akron, Ohio. They established the tradition within the "anonymous" twelve-step programs of using only first names "at the level of press, radio and film."
As AA was growing in the 1930s and 1940s, definite guiding principles began to emerge as the Twelve Traditions. A Singleness of purpose emerged as Tradition Five: "Each group has but one primary purpose -- to carry its message to the alcoholic who still suffers." Consequently, drug addicts who do not suffer from the specifics of alcoholism involved in AA hoping for recovery technically are not welcome in "closed" meetings unless they have a desire to stop drinking alcohol. The reason for such emphasis on alcoholism as the problem is to overcome denial and distraction. Thus the principles of AA have been used to form many numbers of other fellowships for those recovering from various pathologies, each of which in turn emphasizes recovery from the specific malady which brought the sufferer into the fellowship.
In 1953 AA gave permission for Narcotics Anonymous to use its Steps and Traditions.
Twelve Steps
These are the original Twelve Steps as published by Alcoholics Anonymous:
- We admitted we were powerless over alcohol—that our lives had become unmanageable.
- Came to believe that a Power greater than ourselves could restore us to sanity.
- Made a decision to turn our will and our lives over to the care of God as we understood Him .
- Made a searching and fearless moral inventory of ourselves.
- Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
- Were entirely ready to have God remove all these defects of character.
- Humbly asked Him to remove our shortcomings.
- Made a list of all persons we had harmed, and became willing to make amends to them all.
- Made direct amends to such people wherever possible, except when to do so would injure them or others.
- Continued to take personal inventory and when we were wrong promptly admitted it.
- Sought through prayer and meditation to improve our conscious contact with God as we understood Him , praying only for knowledge of His will for us and the power to carry that out.
- Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.
In some cases, where other twelve-step groups have adapted the AA steps as guiding principles, they have been altered to emphasize principles important to those particular fellowships, to remove gender-biased or specific religious language.
Twelve Traditions
Main article: Twelve TraditionsThe Twelve Traditions accompany the Twelve Steps, the Traditions provide guidelines for group governance. They were developed in AA in order to help resolve conflicts in the areas of publicity, religion and finances. Most twelve-step fellowships have adopted these principles for their structural governance. The Twelve Traditions of Alcoholics Anonymous are as follows.
- Our common welfare should come first; personal recovery depends upon AA unity.
- For our group purpose there is but one ultimate authority—a loving God as He may express Himself in our group conscience. Our leaders are but trusted servants; they do not govern.
- The only requirement for AA membership is a desire to stop drinking.
- Each group should be autonomous except in matters affecting other groups or AA as a whole.
- Each group has but one primary purpose—to carry its message to the alcoholic who still suffers.
- An AA group ought never endorse, finance, or lend the AA name to any related facility or outside enterprise, lest problems of money, property, and prestige divert us from our primary purpose.
- Every AA group ought to be fully self-supporting, declining outside contributions.
- Alcoholics Anonymous should remain forever non-professional, but our service centers may employ special workers.
- AA, as such, ought never be organized; but we may create service boards or committees directly responsible to those they serve.
- Alcoholics Anonymous has no opinion on outside issues; hence the AA name ought never be drawn into public controversy.
- Our public relations policy is based on attraction rather than promotion; we need always maintain personal anonymity at the level of press, radio, and films.
- Anonymity is the spiritual foundation of all our traditions, ever reminding us to place principles before personalities.
Process
In the twelve-step program human structure is symbolically represented in three dimensions: physical, mental, and spiritual. The problems the groups deal with are understood to manifest themselves in each dimension. For addicts and alcoholics the physical dimension is best described by the allergy-like bodily reaction resulting in the compulsion to continue using substances after the initial use. For groups not related to substance abuse this physical manifestation could be more varied including, but not limited to: compulsive hoarding, distractibility, eating disorders, dysfunctional enabling, hyperactivity, hypomania, insomnia, irritability, lack of motivation, laziness, mania, panic attacks, psychosomatic illnesses, poor impulse control, procrastination, self-injury and suicide attempts. The statement in the First Step that the individual is "powerless" over the substance-abuse related behavior at issue refers to the lack of control over this compulsion, which persists despite any negative consequences that may be endured as a result.
The mental obsession is described as the cognitive processes that causes the individual to repeat the compulsive behavior after some period of abstinence, either knowing that the result will be an inability to stop or operating under the delusion that the result will be different. The description in the First Step of the life of the alcoholic or addict as "unmanageable" refers to the lack of choice that the mind of the addict or alcoholic affords concerning whether to drink or use again.
The illness of the spiritual dimension, or "spiritual malady," is considered in all twelve-step groups to be self-centeredness. This model is not intended to be a scientific explanation, it is only a perspective that twelve-step organizations have found useful. The process of working the steps is intended to replace self-centeredness with a growing moral consciousness and a willingness for self-sacrifice and unselfish constructive action. In twelve-step groups, this is known as a spiritual awakening or religious experience. This should not be confused with abreaction, which produces dramatic, but ephemeral, changes. In twelve-step fellowships, "spiritual awakening" is believed to develop, most frequently, slowly over a period of time.
It is suggested that members regularly attend meetings with other members who share their particular recovery problem. In accordance with the First Step, twelve-step groups emphasize self-admission by members of the problem they are recovering from. It is in this spirit that members often identify themselves along with an admission of their problem, e.g. "Hi, I'm Wendy and I'm an alcoholic." Such ca
Twelve-step program - Wikipedia, the free encyclopedia
^"Privilege and Confidentiality in 12-Step Self-Help Programs: Believing The Promises Could Be Hazardous to an Addict's Freedom". The Journal of Legal Medicine 26 (4): 435–474.
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