lecture 3 12 step groups and other self help groups

12 step history

• ideologies spawned from christian religious sect “oxford group”

• temperance movement ideas/concepts

• connection to and between struggling alcoholics - bill wilson / dr. robert smith

• bill wilson’s spiritual awakening kind of gives birth to this 12 step journey

12 step and disease perspective commonality

• both use the word “disease”

• addiction to anything is not a symptom of a more serious core issue

• disease is the primary condition that has to be stopped for any progress in treatment to occur

• abstinence is key

12 step group therapy and disease model

• start of treatment is aimed at identifying defences and character deficits that keep you from abstinence and recovery, not uncovering psychological pathology

• relieving underlying symptoms will not bring about recovery or abstinence

• disease can be viewed as lifestyle of behaviours - not so medical

• characterizes you as an alcoholic

• AA doesn’t teach how to handle drinking, but how to handle sobriety

• people don’t go to AA for knowledge, they go for inspiration

• they have to be emotionally moved - motivated

12 step views on abstinence

• it is very much necessary

• if you are an alcoholic, it is key.

• once an alcoholic, always an alcoholic. if you can control your drinking, you were never an alcoholic in the first place

  • connected to hotel california - you can enter but you can never leave

• they argue that viewing yourself as an alcoholic keeps you accountable. the counterargument is that it’s reductionistic and doesn’t lend to the idea of growth and learning

differentiating between substance abusers and addicted sufferers

• heavy drinkers (substance abusers) display less severe physical dependence

• tend to be younger

• tend to not have positive family history of addiction

low bottom/high bottom terminology

the bottom is your crashing point. rock bottom. for some people, this is when they decide they need to turn their lives around. for others, their bottom is death.

high bottom

• ex airline pilot, doctor, surgeon, lawyer

• are sheltered by status, unions, money, etc

• they may eventually have career crashes, but they can turn it around because of the resources and influence they have

• not as severe of a degree of social consequences before recovery

A.A intro

• most frequently consulted source for help w/ drinking problems

• approx. 1 in 10 adults in US has gone to a meeting

• 2/3 of those attended just ONE meeting because of another person’s drinking

• empirical evidence on efficacy of 12-steps is sparse, inconclusive. evidence is sparse because it is ANONYMOUS

AA closed meetings

• designated speakers - 1 member speaking

• theme meetings (aka roundups) - everyone can speak about particular problem

• step meetings - centred around a particular step

how does AA work

• “mirroring” to break through defences - addicted sufferers speaking to addicted sufferers

• you want someone to see through their preoccupation with the “self”

• spiritual aspect - personal growth and learning to be part of something

• a choice is offered - this or that, new life or old life

• requires active participation — accept that you are powerless and your life has become unmanageable

• it challenges your loneliness and the idea that you are the only person going through this

• offers hope and predictability

“bottom line” of AA

• stop looking for a cause and take responsibility for your actions

• realize that YOU are what is causing or problem, not the substance

• this is a lifelong process

narcotics anonymous

• honours 12 steps but is not based on religion - it is a bit spiritual

• is based on abstinence

• calls addiction a disease

• their “god” is good orderly direction

Al-anon and Alateen

• comes from wife of one of founding members of AA - waiting for husband to come out of his meeting

• eventually became family support group

• Alateen — teens of alcoholic parent / alcoholic family. learn to detach from the family member’s behaviour and learn to love the individual despite the addiction

support groups outside the 12 step model

• lots of these are women and/or people less invested in idea of god/spirituality or breaking down personality/defects

• some are abstinence based, some aren’t

• some are groups of women only, some are mixed

• you can still be a part of a 12 step program on the side if you want

common traits of other support groups

• more psychological in nature - CBT oriented

• some groups advised by mental health professionals

• more individual - “you have the potential within you to not use"

• challenge marginalization/oppression/depression/guilt to built self-esteem

• encouraged to leave group when you yourself feel like you’ve recovered — very different from 12 step ideology of once an addict always an addict

• build on what’s positive in your life right now and your current strengths

first 3 steps of AA

1. we admitted that we are powerless over alcohol, and that our lives had become unmanageable

2. we came to believe that a Power greater than ourselves could restore us to sanity

3. we made a decision to turn our will and our lives over to the care of God as we understood him