Long term recovery from addictive and compulsive

The 12 Stairss form the religious and practical anchor of Alcoholics Anonymous ( AA ) – the first dependence recovery plan of its type — and countless other dependence recovery plans modeled after it, including such diverseness of topics as Narcotics Anonymous, Gamblers Anonymous, Sexaholics Anonymous, and Overeaters Anonymous. That the 12 stairss are an built-in constituent of these groups is reasonably common cognition, but the precise content of those 12 stairss and how they fit together to make a operable paradigm to interrupt and indefinitely discontinue the dependence in inquiry, are less normally known, as are their efficacy vis-a-vis other intervention methods. How priceless is spiritualty in the intervention of dependence? Is AA’s version of spiritualty simply another dogmatic look of faith, and is AA’s religious methodological analysis the lone way to recovery?

The 12 ‘suggested’ stairss are as follows:

1. We admitted we were powerless over intoxicant — that our lives had become unwieldy.

2. Came to believe that a Power greater than ourselves could reconstruct us to saneness.

3. Made a determination to turn our will and our lives over to the attention of God, as we understood Him.

4. Made a searching and unafraid moral stock list of ourselves.

5. Admitted to God, to ourselves and to another human being the exact nature of our wrongs.

6. Were wholly ready to hold God take all these defects of character.

7. Humbly asked Him to take our defects.

8. Made a list of all individuals we had harmed, and became willing to do damagess to them all.

9. Made direct damagess to such people wherever possible, except when to make so would wound them or others.

10. Continued to take personal stock list, and when we were incorrect, quickly admitted it.

11. Sought through supplication and speculation to better our witting contact with God, as we understood Him, praying merely for cognition of His will for us and the power to transport that out.

12. Having had a religious waking up as the consequence of these stairss, we tried to transport this message to alkies, and to pattern these rules in all our personal businesss. ( Alcoholics Anonymous, pp. 59-60 )

Clearly, there is asine qua nonconstituent to the religious elements of AA. This is neither an accident nor the consequence of the undue, covert influence of spiritual fiends with no personal experience with alcohol addiction. The establishing male parents of the 12-step motion, Bill Wilson and Dr. Bob Smith ( known as ‘Bill W.’ and ‘Dr. Bob’ to AA members severally ) turned to a spirituality-based attack to suppressing their dependence out of despair, turning to spiritualty merely as a last resort and merely on the suggestion of another individual, i.e. non a spontaneous enterprise. Wilson, a Wall Street investing agent in New York City in the 1930s, had followed an unusual journey on the route to his recovery, meeting a assortment of people who had unusual narratives to state of people pull offing to discontinue imbibing because of religious transition. During his three hospitalizations for intoxicant intervention at Towns Hospital Drug and Alcohol Addictions in New York, Wilson was to a great extent influenced by Dr. William Silkworth, who convinced Wilson that alcohol addiction was neither a moral failing nor a failing of will, but instead an unwellness or an affliction more kindred to an allergic reaction. Silkworth believed that alcohol addiction was a mental compulsion that ran contrary to and trumped rational thought, logic, and the exercising of self-control, which provided a liberating point of position to those who were distraught at the inability of both their loved 1s and themselves to merely make up one’s mind and move on a rational footing to discontinue imbibing. As significantly to Wilson’s eventual success in discontinuing imbibing, Silkworth was familiar with the scholarly work of celebrated psychologist Carl Jung and William James, a profoundly spiritual professor of psychological science and doctrine at Harvard, whose bookThe Assortments of Religious Experience: A Study in Human Natureoutlined a persuasive scientific attack to the apprehension of the psychological science of the transformational power of spiritual experiences in human existences. Of peculiar worth to the intervention of alcohol addiction was James’ description of the spiritual transition of a personality at war with itself:

The transition is the procedure, gradual or sudden, by which a ego hitherto divided, and consciously incorrect, inferior and unhappy, becomes incorporate and consciously superior and happy, in effect of its firmer clasp upon spiritual realities… To state that a adult male is converted agencies in these footings, that spiritual thoughts, antecedently peripheral in his consciousness, now takes a cardinal topographic point, and that spiritual purposes form the accustomed Centre of his energy. ( James, 1902, p. 189 )

The analysis of spiritualty in such psychological footings, as a tool to mend what James famously termed the ‘divided ego, ’ was fresh. Besides making a meaningful nexus between faith and the emerging scientific discipline of psychological science, James’ work illuminated the impression that religious transitions were non simply rapprochement between the human being in inquiry and God from whom he was estranged, but a rapprochement of the alienated and/or warring elements within the divided human ego. And in add-on to innovative philosophical and psychological contemplations about the value and nature of religious transitions, James’ work provided legion inspiring anecdotal illustrations of alkies being cured by such transitions.

For his portion, Jung had besides crossed waies with one of the personalities that formed the nascent impulse towards the official AA motion, an otherwise successful man of affairs named Rowland Hazard who had sought intervention with Jung for his terrible alcohol addiction. Despite a period of intensive therapy, Jung was unable to assist Hazard and bluffly told him that in his clinical experience, there was small hope for alkies even through the procedure of Jung’s fresh trade name of psychotherapeutics, which was an outgrowth of Freud’s theories about the workings of the unconscious human head. Harmonizing to Wilson, Hazard in despair asked Jung for any non-therapeutic suggestions, and Jung told Hazard that his lone hope was a bona fide religious transition. Upon Hazard’s return to the United States after his audiences with Jung, he joined a Christian organisation called the Oxford Group, whose instructions subsequently became the direct inspiration for stairss three through 12 of AA, the stairss sketching a person’s entire resignation to God and the on-going moral stock list and doctrine of damages. Hazard was inspired by the successes of Oxford Group members in get the better ofing their alcohol addiction, and shortly became a convert himself, in bend change overing Ebby Thacher, a former imbibing comrade of Bill Wilson.

The freshly and proudly sober Thacher sought out and visited his old friend Wilson and seriously explained that he had, as the proverb goes, “found faith, ” and that God had accomplished for Thacher what Thacher – and countless others – had been unable to make for himself despite heroic battles. Wilson was disbelieving of organized faith in general, though he was open-minded to the impression of spiritualty, and peculiarly disbelieving of Thacher’s newfound evangelical ardor. Nonetheless, Wilson found Thacher both enthusiastically spiritual and enthusiastically non-dogmatic. The latter was unexpected. Wilson described what followed:

Despite the living illustration of my friend at that place remained in me the traces of my old bias. The word ‘God’ still aroused a certain aversion. When the idea was expressed that there might be a God personal to me this feeling was intensified. I did n’t like the thought. I could travel for such constructs as Creative Intelligence, Universal Mind or Spirit of Nature but I resisted the idea of a Czar of the Heavens, nevertheless loving His sway might be. I have since talked with tonss of work forces who felt the same manner. My friend suggested what so seemed a fresh thought. He said, ‘Why do n’t you take your ain construct of God? ‘ That statement hit me difficult. It melted the icy rational mountain in whose shadow I had lived and shivered many old ages. I stood in the sunshine at last. (Alcoholics Anonymous, p. 12 )

Wilson’s transition shortly followed and he ne’er drank intoxicant once more. The about absurd simpleness of Thacher’s non-insistence upon a dogmatic, Christian construct of God being a requirement to accessing the power of a religious transmutation became the foundation of the “as we understood him” corollary to step three. Despite this evident openness, AA still must, by definition, happen its methods incompatible with those who do non believe in a higher power.

Why is the constituent of religious transition so critical to the 12 stairss? Why was it necessary, for illustration, to give up God, any other supreme being, or for that affair any other human being, in order to understand one’s alcohol addiction as illness and to execute unafraid moral stock lists of oneself, and do damagess to 1s who had been wronged by one’s alcohol addiction? That necessity is a topic of intense argument – which we shall discourse subsequently – but to the extent that religious transitionisnecessary, the reply to why prevarications possibly most compactly in the contents of a singular missive that Jung wrote to Wilson after Wilson had foremost written Jung in 1961 to thank him for his parts to the metaphysical underpinnings of AA. As thorough and accomplished a scientist as Jung was, he was besides a profoundly spiritual adult male whose spiritualty informed and complimented, instead than contradicted his work as a psychologist. Reacting to Wilson’s reference of Hazard’s experiences with him, Jung offered these contemplations:

[ Hazard’s ] hungering for intoxicant was the equivalent, on a low degree, of the religious thirst of our being for integrity, expressed in mediaeval linguistic communication: the brotherhood with God. [ i.e. “ As the Hart panteth after the H2O Brooks, so panteth my psyche after thee, O God. ” ( Psalms 42:1 ) ” ] The lone right and legitimate manner to such an experience is that it happens to you in world and it can merely go on to you when you walk on a way which leads you to higher understanding. You might be led to that end by an act of grace or through a personal and honest contact with friends, or through a higher instruction of the head beyond the confines of mere rationalism. I see from your missive that [ Hazard ] has chosen the 2nd manner, which was, under the fortunes, evidently the best one… You see, “ intoxicant ” in Latin is “ spiritus ” and you use the same word for the highest spiritual experience every bit good as for the most perverse toxicant. The helpful expression therefore is:spiritus Contra spiritum. ( Thomsen, pp. 362-363 )

In other words, the lone solution for recidivistic alkies such as Hazard or Wilson was to wholly replace the illusory ecstasy derived from the ingestion of intoxicant with the rapture, which Jung seemingly believed was anything but illusory, of the religious chase of the rapprochement with God. Jung’s missive besides offers a silent recognition of a fact that many scientists are loathe to acknowledge, or at least acknowledge its cogency, that the blunt empirical construction of scientific discipline is sometimes merely unequal to offer the deepness of apprehension of the cryptic workings of the human psyche and of the greater truths of the universe itself that so many people – alkies or non – crave with great passion. As successful a psychologist as Jung was, he was unable to assist Hazard with scientific discipline, but his egoless suggestion that Hazard seek a non-scientific agencies to suppress his alcohol addiction opened a door to a way for Hazard that led to both his and Wilson’s recovery. He acknowledged that logic was the beginning of wisdom, but barely contained its terminal, which at some point justly fell under the horizon of religion. At its nucleus, AA is a contemplation of the uneasy relationship between the power of rationalism – the 12 stairss are themselves, by being logical in construction and sequence, an exercising in logic – and spiritualty.

However, AA is non ever as radically successful with all who seek a remedy within its stenosiss as it was for Wilson and the 1000000s who have followed in his hard personal journey. There is obliging recent scientific informations demoing that engagement in AA had definite favourable long-run impact in the cut downing the return of alcohol addiction, including a 2006 Stanford University study by Rudolf & A ; Rudolf which showed that alkies who participated in AA for 27 hebdomads or more had better 16-year results. However, this survey did non adequately address the issue of whether alkies who sought aid from AA were statistically successful in for good discontinuing their imbibing, which AA states as its end. An highly cursing survey was conducted in 1983, whose consequences were reaffirmed in 1995, by one of the legal guardians of Alcoholics Anonymous World Services, Inc. , George Vaillant of Harvard University, which showed that 95 % of patients in a assortment of surveies who had attempted to battle their alcohol addiction through AA had relapsed at some occasion during the legion old ages that Vaillant studied them. Vaillant surmised that AA was no more effectual at bring arounding alcohol addiction than was merely allowing the affliction take its natural class, i.e. no intervention at all. Most disturbing was Vaillant’s decision that “Not merely had we failed to change the natural history of alcohol addiction, but our decease rate of three per centum a twelvemonth was appalling.” ( Vaillant, p. 352 ) However, Vaillant has continued to stay a vocal protagonist of the rules of AA and his surveies, while clearly bespeaking the trouble alkies face in seeking to for good discontinue their ingestion of intoxicant, besides show that over the class of the eight old ages of his initial survey, 45 per centum of alkies studied had either managed to discontinue imbibing wholly or go moderate societal drinkers. They key to their success was in non giving up when they ‘fell off the wagon.’ Possibly the most distressing survey was Brandsma et Al. ( 1979 ) , who found a correlativity between AA and an increased rate of orgy imbibing. Brandsma surmised that AA’s demand that participants admit they were powerless to halt imbibing became a self-fulfilling prognostication for some members who were unable to see a religious transition. Brandsma’s survey indicated that those who had participated in AA for several months were five times more likely to get worse in the signifier of orgy imbibing than those who had experienced no intervention, and nine times more likely to get worse in the signifier of orgy imbibing than patients in the survey who were treated with Rational Emotive Behavior Therapy ( REBT ) , a signifier of psychotherapeutics that takes an about opposite attack to AA – that patients are so powerful plenty to halt imbibing and can make so by doing the cognitive association between enticement to imbibe intoxicant and assorted irrational emotions that trigger the kind of suicidal urges that underlie alcohol addiction: “When people keep disputing and oppugning their self-disturbing nucleus doctrines, after a piece they tend to automatically, and even in progress, conveying new, rational, self-helping attitudes to their life jobs and thereby do themselves significantly less upsettable. ” ( Ellis, 2003 ) . The less upsettable the patient, the less likely they are to imbibe ( or overeat, or move out sexual irresistible impulses ) . Other healers, such as Dr. Phillip Flores, advocate interpersonal group therapy ( IGP ) as a means to supply healthy interpersonal relationships, trusting on the theoretical theoretical account that

dependence is … an attachment upset caused by familial and early developmental failures that lead to faulty efforts at self-repair. The substance maltreater efforts to replace drugs and intoxicant for satisfactory interpersonal relationships… [ IGP ] members become able to associate successfully to people outside of the group without the demand to turn to substances of maltreatment through the development of healthy relationships in the group. ( Brook, 2003 )

Flores advocates the combination of such methods as IGP with traditional 12-step recovery plans, observing that there is “an emerging grasp for the advantages of group therapy, and it is no longer viewed as an inferior or secondary method of treatment.” ( Flores, 1997 ) , while at the same time admiting the restrictions of rational idea and scientific discipline and recommending the usage of 12-step groups such as AA to bridge the spread between that restriction and the metaphysical angst of the nut ( Flores dedicates an full chapter to the geographic expedition of AA’s alone ability to augment scientific discipline with religion ) .

The cardinal issue, so, with regard to spirituality’s part to intervention of, and recovery from, the panoply of assorted dependences, is whether or non the spiritualty an nut chooses to encompass must needfully be exactly along the lines of what the dogmas of AA demand: a complete resignation to whatever the addict’s construct of God is. Unfortunately, this needfully excludes two important groups: 1 ) pure atheists, who believe faith and spiritualty are so the destructive opiate of Marx’s Hagiographas, and see no advantage to give uping to a power in which they do non believe, and 2 ) those who are unfastened to the usage of organized faith and spiritualty but have a cardinal dissension with the cardinal construct behind AA’s relationship with a higher power: that nuts are powerless to get the better of their dependence and the lone manner to make so is to wholly give up themselves to the higher power, an act of religion which may be inherently take downing to the self-pride of the nut, potentially declining the job as Brandsma et Al. suggested. Some former AA members have derided the organisation for showing cultish inclinations. A recent article inNewsweekmagazine painted a distressing image of one of Washington, D.C.’s largest AA chapters, in which “recovering alkies and mental-health professionals describe a group that exerts an unusual sum of control and sometimes seems to set the societal desires of some members above the recovery of others.” ( Summers, 2007 ) AA’s ain ‘Big Book’ does non ever seen Tis make allowances for either the possible failure of the AA manner, or the possibility that there are other valid methods to handling dependence successfully than AA’s, doing the brave claim – hard verify or confute with empirical informations — that “rarely have we seen a individual fail who has exhaustively followed our way. ” (Alcoholic Anonymous, p. 58 ) In truth, 95 % of those who have followed AA’s way fail at least one time, as Vaillant’s surveies showed. Can it be reasonably said of those who fail that they have non exhaustively followed AA’s way of complete resignation to God?

Many creative-minded mental wellness professionals are presently recommending a in-between land between the arguably stiff spiritual constructions of AA and methods of psychotherapeutics that reject faith or spiritualty wholly, including William Miller, who edited a 1999 aggregation of essays offering practical intervention advice for nuts that integrates spiritualty. Miller warns explicitly that “religion… can, in fact, interfere with a person’s religious growing, ” ( Miller, p. 7 ) , traveling on to recommend the point of view that none other than AA’s metaphysical initiation male parent William James was depicting spiritualty, non faithper Se, inThe Assortments of Religious Experience. Ultimately, so, the pick in intervention of dependence should non be limited to a binary one, between spiritualty and/or faith in intervention versus no spiritualty and/or faith in intervention of dependence, but credence of the impression that there is room for a assortment of efficacious methodological analysiss which lie along the continuum between both extremes.


Alcoholics Anonymous: The Story of How many Thousands of Men and Women Have Recovered from Alcoholism/ a.k.a.The Big Book( 1955 ) , New and Revised Edition ( Second Edition ) , New York: Alcoholics Anonymous Publishing, Inc.

James, W. ( 1902 ) .The Assortments of Religious Experience: A Study in Human Nature. New York and London: Longmans, Green and Co.

Finlay, Steven W. ( 2000 ) . “ Influence of Carl Jung and William James on the Origin of Alcoholics Anonymous ” .Review of General Psychology, V4: 3-12.

Thomsen, Robert. ( 1999 ) .Bill W. : The Absorbing and Deeply Moving Life Story of Bill Wilson, Cofounder of Alcoholics.Hazelden Press.

Moos, Rudolf & A ; Moos, Bernice. ( 2006 ) . “Participation in intervention and Alcoholics Anonymous: A 16-year followup of ab initio untreated individuals.”Journal of Clinical Psychology, Vol. 62, Issue 6, pp. 735-750.

Valliant, George. ( 1995 ) .The Natural History of Alcoholism Revisited. Cambridge, MA: Harvard University Press.

Brandsma, Jeffrey, Maxie Maultsby, and Richard J. Welsh. ( 1979 ) .Outpatient Treatment of Alcoholism. Baltimore, MD. : University Park Press.

Ellis, Albert ( 2003 ) . “Early theories and patterns of rational affectional behaviour theory and how they have been augmented and revised during the last three decades.”Journal of Rational-Emotive & A ; Cognitive-Behavior Therapy, Volume 21, Issue 3 & A ; 4.

Brook, David. ( 2003 ) “Exploring Group Therapies, ”Psychiatric Timess, 1 February 2003.

Flores, P. J. ( 1997 )Group Psychotherapy with Addicted Populations. The Haworth Press.

Summers, Nick. ( 2007 ) “A Struggle Inside AA, ”Newsweek, 7 May 2007 issue.

Miller, W. R. ( Ed. ) ( 1999 ) .Integrating Spirituality into Treatment: Resources for Practitioners. Washington, DC: American Psychological Association.


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