The Science Supporting the 12 Steps “… therapy based on the kinship of common suffering…”
~The Big Book, Appendix IV, the Lasker Award, p. 571
Over 75 years ago, an Ohio surgeon and a New York businessman founded a mutual aid fellowship with the goal of helping alcoholics achieve and retain sobriety. This fellowship developed a set of guiding principles designed to help the recovery process – physically, mentally, emotionally, and spiritually.
Although this fellowship – known today as Alcoholics Anonymous– was created specifically for people whose lives were being destroyed by alcohol, the philosophy behind the guiding principles can be applied universally to anyone suffering from an addiction.
Today, there are support groups for almost any problematic compulsion – Crystal Meth Anonymous, Cocaine Anonymous, Narcotics Anonymous, Gambling Anonymous, etc. – and the majority of professional inpatient and outpatient treatment facilities incorporate some version of Alcoholics Anonymous’ original tenets.
These guiding principles are known as the “12 Steps”, and they serve as a step-by-step outline of the path leading from suffering to serenity to service that can be realized by anyone who finds themselves powerless over an addiction that has made their lives unmanageable.
For years, critics of 12-Step programs have scoffed at the idea that the supportive efforts of lay people – especially other addicts – could in any way produce meaningful positive results. That tide of thought may be changing as more and more studies are strongly suggesting that participation in a 12-Step program offers a “statistically significant advantage” over different stand-alone approaches when total abstinence is the goal.
Robert Fiorentine, PhD, Director of Research Training at UCLA’s Drug Abuse Research Center, said, “There has been hostility among researchers, partly because of the spiritual emphasis of AA. There is still hostility, but because the recent evidence indicating the effectiveness of the 12 Steps in assisting in recovery, this hostility among researchers seems to be diminishing.”
It is true that addictive disorders cause suffering but it is also true that the worst fate is to suffer ALONE. Some believe that addicts often have problems forming emotional bonds with other people, even before their addiction manifests itself.
When the psychological mechanisms that allow for healthy human attachments aren’t functioning properly, other co-occurring disorders can result, such as social anxiety or depression. These new problems can make it even harder for those suffering to connect with others, creating a vicious psychic circle.
To ease this pain, some may turn to harmful or addictive substances and behaviors – alcohol, drugs, gambling, shopping – anything to escape the isolation and disconnection that they are feeling.
However, whatever short-term relief that they find is quickly lost again when their addiction wreaks havoc on the other areas of their lives, further hindering their ability to make essential emotional connections.
Philip Flores, PhD, an Atlanta-based clinical psychologist who authored Addiction as an Attachment Disorder, likens addiction to “an attempt at self-repair that fails”, explaining why some vulnerable people try to make up for their lack of human connections by substituting chemical solutions. The book links the physiological human need for social interaction with others with the overall well-being of the nervous system.
Flores goes on to say, “Addicts don’t want to engage in these behaviors, but they can’t control themselves. The only way to be truly treated is with something more powerful. We, as social mammals, cannot regulate our central nervous systems by ourselves. We need other people to do that.”
Flores is also quoted as saying that a 12-Step group is a “community for people to break the isolation and to start to connect on an emotional level with other people.”
Research into alcoholism and addiction has come a long way from the dark days when these diseases simply thought of as moral weaknesses. A definite connection between neuroscience and psychological counseling has been uncovered, to the point where it is now generally understood that group talk therapies such as 12-Step programs help to normalize the reward pathway of the brain, helping correct neurotransmitter systems that have gone haywire.
Often cited as the definitive work determining the effectiveness of 12-Step programs, the Project MATCH Study makes the optimistic implication that “by incorporating 12-step facilitation into treatment, providers can increase the likelihood that patients will continue to improve, even after professional treatment has ended.”
The director of the Project MATCH study, Joseph Nowinski, PhD, is a clinical psychologist who has taught both at the University of California San Francisco and the University of Connecticut. His book, If you work it, it Works! The Science behind 12 Step Recovery,” is an excellent insight into what makes the 12-Step approach so successful.
What does all this mean?
It means that when an individual burdened with an addiction that is disrupting their life and ability to function, their best chance at recovering from that addiction is participation in a treatment program that includes among its services the guiding principles of the 12 Steps – those same steps that have helped generations of alcoholics and addicts around the world.