April 26th, 2016
In 1935, when Bill Wilson and Robert “Dr. Bob” Smith created AA, both were members of a then-popular Christian revival movement known as the Oxford Group. In fact, the Steps themselves were based on the Oxford Group’s principles of surrender to God, confession, prayer and service. But AA soon split off from the Oxford group, which had been founded by a controversial preacher named Frank Buchman (just before the split, Buchman did not help his reputation when he praised Hitler and sought to convert the Nazi leadership into becoming his followers)(1). AA wanted to be a more ecumenical organization and the Oxford Group did not want its primary business to be converting drunks, which made the parting mutual.
So how did a Jewish girl from Manhattan embrace and later come to question what I now see was designed as a Christian form of recovery? And why don’t I advocate the 12 Steps for all, since they apparently worked for me during the critical first five years of my recovery? Well—like every other issue in addiction—it’s complicated.
For me, it started in rehab in 1988, at a program, now closed, in Westchester, New York, which was a typical Minnesota-model, 12-step, 28-day treatment. Specifically, I began to feel like I might be able to accept the program when I first heard an AA speaker who happened to be a doctor. He made life in recovery sound more like fun and less like the tedious drudgery of constantly having to try to avoid everything I loved, from sugar to music, which was what others seemed to highlight. He was an outside speaker and he talked more about what he got from recovery than what he’d given up.
In rehab, too, I was immersed in a milieu where every authority seemed to endorse the Steps as my only hope. Because medical professionals—from the hospital detox doctors and nurses to the rehab physician and counselors to the AA doc—accepted what seemed like religion as actual medicine, I thought that there had to be strong science behind it. Since these apparent experts told me both that addiction was a medical disease and that the treatment was meeting, confession and prayer, I didn’t notice the contradiction that is now obvious to me when stating these facts.
Instead, it was a relief to see addiction as a disease and to know that while I was responsible for my recovery, the fact that I’d gotten hooked didn’t mean I was a bad person. In meetings, I’d hear others talk about how they had hated and blamed themselves—and how the steps were the key to making past wrongs right. I knew that I needed to find some way to get over my sense of failure about the disastrous wrong turn my life had taken. Since I’d left Columbia College, I’d found my future unbearable without drugs.
In the program, I learned that if I could just stop hating myself for hating myself, I didn’t feel quite so bad. While the Steps didn’t formally address the issue, in meetings I’d hear people talk about swinging from grandiosity to self-loathing, often described in AA’s earthy language as “feeling like the piece of shit in the center of the universe” or being “an egomaniac with an inferiority complex.” I knew exactly what they meant and felt understood. Another slogan that helped was “don’t compare your insides to someone else’s outsides,” meaning that most people try to present the best parts of themselves, but you can’t hide your negative aspects from yourself. This concept is especially useful in the age of social media.
Simply hating myself was bearable if unpleasant; hating myself for doing so on top of that was not. And hearing friends, whom I knew to be good and kind, describe their own self-loathing helped me see how incorrect self-perceptions could be. This allowed me to ease up on myself, which reduced my need for escape. I began to learn the critical recovery skill of self-compassion.
Part of what the program gave me was hope: what AA calls the “power of example.” Seeing people similar to me get better made a real difference—and I still think that this is often a crucial element in recovery. Although research shows that whether a counselor has his or her own addiction history does not affect outcomes (2), some contact with people who have been there and recovered often matters.
In fact, research suggests that the supportive community that 12-step programs provide is the main active ingredient in their success, when they work. The data is clear that social support aids both mental and physical health—and that people with more of it are much more likely to recover. Social support is the single most important factor in mitigating severe stress and trauma (3), which often contribute to addictions. Love doesn’t always cure all—but without it, healing from psychological and learning disorders is almost impossible. We all tend to learn best when we feel safe and curious and want to connect and win our teachers’ respect.
I also found some specific elements of the 12-step structure and literature helpful, beyond its large, welcoming community. For one, when you go to meetings daily, you hear thousands of stories and comments. Few other opportunities exist to hear people discuss their challenges and the mundane thoughts that disturb or distress them. With friends, partners and families, we often want to hide this part of ourselves, so as not to upset or bore them—or, sometimes, because we don’t want to display weaknesses or give those who might hurt us additional weapons.
Read more from The Influence:
But in a meeting full of strangers or semi-strangers, the need for positive self-display is less pressing. For me, listening to a well-known model discuss how ugly she thought she was or hearing a renowned journalist discuss how he saw himself as a failure came with the hopeful suggestion that there was some possibility that my own negative ideas might be similarly deluded. And just hearing others admit their anxieties, fears and hopes inevitably helps ground you.
Similarly, the same clichés that originally put me off sometimes held important truths. The rhyme “put gratitude in your attitude” still sets my teeth on edge. However, I recognized that I did genuinely have a tremendous amount to be thankful for and that focusing on this, in part simply by taking up mental energy, could push out negative thoughts and make me feel better. In the same way, the cheesy sign that said HALT, which stands for “Don’t get too Hungry, Angry, Lonely or Tired,” gave me clues about what physical and emotional needs to take care of when I seemed to want drugs out of the blue. Sure enough, I’d often discover that a “drug craving” was actually hunger, irritation or a need for sleep or social contact, which I could manage without resorting to heroin.
I later realized that the 12-step slogans are basically the groups’ collective wisdom about how to deal with stress, anxiety and other issues that could lead to relapse. In fact, the many of the same ideas found in these often corny and haphazardly-introduced sayings are the backbone of cognitive behavioral therapy (CBT) for addictions. This type of CBT is focused on the learned aspects of addiction and recovery and is one of the most effective treatments currently available (4), though sadly, it can be hard to find rehabs and therapists who actually utilize it as designed. CBT is far more systematic than randomly hearing slogans in meetings and doesn’t complicate matters by moralizing, but nonetheless, if you go to enough meetings and get a sponsor, you are likely to learn much of what CBT recommends eventually.
Ironically, however, I also found the explicitly moral and spiritual parts of the program helpful—and yes, these are the same ones I still strenuously object to as medical prescriptions.
But in my first months and years of recovery, I did find hope in the idea of a Higher Power, before the contradictions in the idea that “everything happens for a reason” became too great for the child of a Holocaust survivor.
This article is excerpted and slightly adapted from Maia Szalavitz’s acclaimed new book, Unbroken Brain: A Revolutionary New Way of Understanding Addiction, which is available now on Amazon.
(1) Connections between Oxford Group, Nazis and AA: Robertson, Nan. Getting Better: Inside Alcoholics Anonymous. Fawcett Crest, 1988. Pp.17-56
(2) Whether a counselor has his or her own addiction history does not affect outcomes: Aiken LS, LoSciuto LA, Ausetts MA, Brown BS. Paraprofessional versus professional drug counselors: the progress of clients in treatment. Int J Addict. 1984 Jul;19(4):383-401
(3) Brown B, Thompson R (1975-76) The effectiveness of formerly addicted and nonaddicted counsellors on client functioning. Drug Forum 5: 123-128.
(4) CBT is one of most effective therapies for addiction: McHugh, R. K., Hearon, B. A., & Otto, M. W. (2010). Cognitive-Behavioral Therapy for Substance Use Disorders. The Psychiatric Clinics of North America, 33 (3), 511–525. doi:10.1016/j.psc.2010.04.012
Maia Szalavitz is a columnist for The Influence. She has written for Time, The New York Times, Scientific American Mind, the Washington Post and many other publications. She has also authored six books, including Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids (Riverhead, 2006). Her last column for The Influence was “Why the ‘Disease Model’ Fails to Convince Americans That Addiction Is a Health Issue.” You can follow her on Twitter: @