12 Steps

12 stepsThere are a few people in my experience who are as impressive in maturity and integrity as those people we have worked with who have been the most involved in 12 Step Programs.

I didn’t come to this observation from any pre-conceived bias in favor of 12 Step Program. If anything, my involvement with 12 Step early on was pretty negative. It was almost universally true, 15 or 20 years ago, that 12 Step Programs tended to view all psychiatric medications as “psychoactive substances” that were to be avoided. I sometimes run into this bias still, but nowadays most 12 Step meetings are far from this anti-mental health bias.

But back to the original comment. I was talking with a wonderful attorney that I’ve had an opportunity to work with and get to know for a few years. That conversation reminded me of other conversations with longtime AA members. Most of them were, as this attorney said, ne’er do well’s in their youth who caused a lot of trouble and a lot of pain, but eventually found the will to stop using substances through a slow process of increasing involvement in 12 Step Programs as participants and then sponsors.

This gentleman noted something that we’ve also seen, which is how often people will start out in AA (Alcoholics Anonymous) and gradually move into Alanon. He described AA this way: “It’s about getting people who are being extremely selfish to think about others and become more selfless.”

On the other hand, Alanon, he said, is about teaching people how to take care of yourself well and it involves learning how to say no sometimes. In AA, you almost never say no.

We don’t know if it is common wisdom or just something that he has noticed (as have we) but it points to the interesting relationships between 12 Step Programs and psychological self-awareness. Some of the programs are more psychologically minded.

Although AA can seem rigid and inhospitable to psychological concepts, the people that we are thinking of have found ways of accommodating ideas like “a higher power” and some of the other concepts that may be difficult in 12 Step Programs. They found a way of giving personal meaning to these concepts and making use of them in their lives, rather than rebelling against them.

Those who made use of 12 step effectively decided that, if there were concepts that they could not make sense of, they left those ideas behind and focused on the many things that were useful. This is an that our colleague and friend Matt Tierney often recommends to those he works with: “take what works and leave the rest behind.”

For More Information

4 Ways You Can Help a Loved One Cope with Addiction and Mental Illness

Alcoholics Anonymous


Alcoholics Anonymous

Alcoholics Anonymous Meeting               Alcoholics Anonymous is many things, and its role changes over time for those who remain involved in it long term.

Most importantly, AA can be a life line for those who are suffering from the potentially fatal illness of substance abuse. It is a way of achieving freedom from alcohol and drug addiction with the help of supportive peers who have “been there.” At these times AA is about dealing with urgent and basic struggles.

For most people going to an AA meeting evokes both a wish to achieve sobriety and a sense of distrust of any “authority”. This distrust can be enhanced by early experiences because some people deal with the stress of new sobriety by throwing themselves into AA as if it is a missionary religion. Those who are wary about this enthusiasm may feel as if they are the only ones with those doubts, but they aren’t. We have been surprised to find out how often long time AA members will talk about profound misgivings they had when they went to their first meeting.

In the long run, personal success in AA comes with some level of acceptance of the structure itself, which supports people in dealing with the impulse to do self-destructive things in response to psychic anxiety and pain. The supportive structure can be sustaining on a long term basis.

Sometimes AA is falsely felt to be at odds with therapy.

The truth is that AA can supplement therapy, as therapy can supplement AA.

The goal of AA is to achieve a genuine stability and relatedness to others that is essential for those with substance abuse issues and also to deal with overwhelming shame that can make it hard to take care of these problems.

The goal of therapy is to move beyond the negative and to find ways of recapturing the positive qualities that have been twisted or deformed through life experiences.

Both AA and therapy need very powerful grounding in a sense of hope and optimism, and a clear vision of possibilities that are “tailored” to individual needs, and to changes in those needs.

For more information we recommend these sites:

AASF – The AA website with the comprehensive meeting schedule for San Francisco and links to other Bay Area counties meetings. Very complete.

SFNA – The Narcotics Anonymous website for SF. Also a very complete meeting schedule.

womenforsobriety.org – We think this is really worth reading. Women for Sobriety is a peer support groups for women in substance abuse recovery. It is non-12-step oriented, but has a very empowering message.

An Interview You Don’t Want to Miss!

Dr. Forster receninterviewtly interviewed with Matt Tierney, a Nurse Practitioner who holds a Master of Science degree in Nursing from UCSF. Matt goes into great detail about the benefits of the 12 step program and what the program is all about. He tells us how the 12 step program can be different for each individual and how each step can take on new meaning as time progresses. This interview also goes into detail about the innerworkings of a relationship with the 12 step program, the value in finding a home AA group, and the importance of having support.  Matt also gives us insight about an individual’s relationship with a sponsor and whether or not a sponsor is necessary to the program. The interview closes with a discussion about doing long term step work and how to make the most out of a 12 step program. To get the scoop about the 12 step program from Matt Tierney, use the link below to see the full interview!

Matt Tierney Part 1