The Science of the 12 Step Program
What is this 12-step program in the world of medical care and treatment? It is a set of guidelines that consists of principles which outline a specific course of action for patients recovering from addiction, obsessive compulsive disorders and miscellaneous behavioral issues. It was initiated by AA (Alcoholics Anonymous), an addiction rehab group and it includes methods of recovery from alcoholism and drug addiction.
This twelve-step program of recovery was first published by Alcoholics Anonymous in its book `Alcoholics Anonymous: The Story of How More Than One Hundred Men Have Recovered from Alcoholism’ in 1939.
This science has been summarized by American Psychological Association as a process which involves admission by the patient suffering who is trying to control is or her alcoholism, compulsion or addiction. This system of self-treatment involves recognition of a higher spiritual power that becomes the source of receiving mental and emotional strength. It also involves examination of errors committed in the past with the help of sponsors or experienced members of this treatment process. The patient has to sincerely make amends for the errors he or she has committed and learn to live a new kind of life with new codes of behavior. The twelve-step process eventually empowers the addict to help others like him or her suffering from alcoholism, compulsion or addiction.
What does this recovery system help in treating?
The twelve-step addiction recovery treatment program has been successfully adapted for the purpose of addressing a vast range of substance-abuse, alcoholism and dependency issues. Over two hundred self-help organizational units that are referred to as `fellowships’ are now using these twelve-step recovery system with a membership that stretches over a couple of millions all over the world.
The science of the twelve-step addiction recovery system has helped many addicts quit their compulsions on their own and gradually reduce their drug or alcohol intake. After entering the twelve-step program and fellowships, several addicts have been able to achieve total abstinence.
Why do people succumb to compulsive addiction?
People become slaves of their habits, leading to compulsion and addiction to alcohol and drugs. This is due to the neurological pull at a subconscious level which undermines survival drives in people. It causes individuals to make some disastrous kinds of choices. People start risking their lives regularly and continue to drink excessively or use drugs or substances above reasonable limits. Addicts actually would not like to engage themselves in such behaviors but they feel that they are in control of their urges.
The twelve-step system is perhaps the strongest way to influence such people and treat them powerfully. The system has shown that it can lead to spiritual enhancement and that it could possibly change the patterns of how the brain functions. The need for interacting socially is a physiological one for humans and it is linked to the healthy being of the nervous system. When a person becomes addicted to alcohol or drugs, his or her mechanisms for developing a healthy attachment suffer and this results in heavy dependence on addictive substances and alcoholism.
Summary of the Twelve-Step System of Recovery
With the twelve-step system of recovery, many rehabilitation fellowships have successfully attempted the identification of personal differences and they have been able to achieve this after clarification of the molecular neurological foundation of every single step of this program. These steps have had a deep influence on the Reward Deficiency syndrome (RDS) despite those addiction risk polymorphisms of genes.
Step 1– This is the stage of admission by the addict that he or she is powerless over alcohol and drugs and that life has become unmanageable. This step and the admission of being powerless has invited plenty of controversy by medical experts but it brings about a realization in the patient that powerlessness over a specific addiction is always supported by actual mechanisms that are involved in the brain’s neurobiological circuits.
Step 2 – The addict comes to believe that a spiritual power greater than him or her will help the restoration of physical and emotional control and preservation of sanity. The ability to make a sound judgment or repetitive behavior bordering on insanity despite harm and risks could get impaired at birth itself and this may be the result of a deficient reward circuitry function in the brain, resulting in a `hypo-dopaminergic’ trait.
Step 3 – The addicts make a conscious decision of turning their will and their lives over to the Almighty Creator’s care. It is not easy to control will power, particularly by those individuals who are born with a compromised reward system and with low levels of endorphins in their bodies. Individuals who are genetically predisposed look out for alcohol, cocaine, heroin, nicotine or excess glucose.
Step 4 – Patients with addiction have to explore their own selves within and take a moral inventory of their actions. This inventory will have to include their drugs of choice and behavior elated with RDS because the phenotype involved is not any specific drug or drugs or even their behavior. It is the deficiency reward syndrome itself.
Step 5 – This phase requires admittance by the patients of the absolute nature of their wrongs in terms of addiction and compulsive behavior to God, and to other fellow men. During this step, the addicts have to make a conscious realization of the dangerous and toxic effects that are brought about by continual exposure to alcohol and drugs.
Step 6 – The addicts have to be ready in this phase to have God remove all their character defects and to accept responsibility of their wrong decisions. This is because an individual’s character gets molded by genetic and evolutionary forces that are beyond that person’s control.
Step 7 – The patients/addicts ask God to help them overcome their shortcomings and they pray with humility and their sincere efforts of improving their condition have to be carried out with grace and gratitude.
Step 8 – A complete list is made during this phase of all the people that may have been harmed by the compulsive behavior of the addicts/patients. These addicts should then be willing to make amends and recompense all those who have been affected by their irresponsible behavior. This responsibility comes naturally after a period of being sober and clean.
Step 9 – Patients have to make direct amends wherever possible during this phase. Such correction in behavior is particularly applicable to the immediate person with whom the addict is in a relationship, such as his or her spouse, family members or children.
Step 10 – The tenth step works like a valve that relieves pressure. Addicts have to work out this step of admitting their wrongs to their dear ones while the ups and downs of a day are fresh in their memory. They have to list out what they have done during the day and rationalize the impact of their actions.
Step 11 – Addicts have to consciously improve their ability to connect with God through meditation and prayer. The prayer has to be for the knowledge of God’s will and their purpose in life and to ask for that power to carry out God’s will. This step will offset the hypo-dopaminergic function of the brain which is induced genetically.
Step 12 – This is the final step where the patients/addicts go through a spiritual awakening after going through the previous steps. Their main purpose then has to shift to carry out this message to other people under the influence of alcohol and drugs.
In this program, the human structure gets represented symbolically in three kinds of dimensions – physical, spiritual and mental. The problems dealt with by the group of addicts get manifested in every dimension.
``Is sobriety all that we are to expect of a spiritual awakening? No, sobriety is only a bare beginning; it is only the first gift of the first awakening. If more gifts are to be received, our awakening has to go on. As it does go on, we find that bit by bit we can discard the old life - the one that did not work - for a new life that can and does work under any conditions whatever.``
More Evidence Based Therapies
COGNITIVE BEHAVIORAL THERAPY: designed to aid patients from a wide range of mental health concerns
CONTINGENCY MANAGEMENT: an effect substance use treatment
DIALECTICAL BEHAVIOR THERAPY: There are four important therapeutic tools in this therapy
FAMILY SYSTEMS THERAPY: draws from the concept of family as an emotional unit.
MOTIVATIONAL ENHANCEMENT THERAPY: the basis of MET is used to increase motivation and construct a plan for further change
MOTIVATIONAL INTERVIEWING: a patient-centered therapy style
PSYCHODYNAMIC PSYCHOTHERAPY: a form of depth psychology