Demystifying 12-Step Programs

By Mary Greiner

If you are bewildered by the workings of 12-step programs but think that you or someone you know might benefit from one, this article is dedicated to you.  If someone (or more than one person) has recommended that you check out a 12-step program, but you don't think that you have an addictive or compulsive behavior, you can find information  here in case you change your mind.  If you are trying to get a loved one into recovery, you can read this article in the context of how 12-step programs such as Al-Anon might be of assistance to you as well.  If you are merely curious, I hope you will learn more about the largest public health issue facing our country today.

The insights in this article come from personal experience, study of both 12-step literature and scientific research, and the gracious contributions of many friends and colleagues.  My deepest thanks go to those in recovery who are willing to share their experiences, strength, and hope with others.  Any errors are mine alone.

Alcoholics Anonymous (AA) is the original 12-step program.  AA support groups focus on recovery issues related to use the drug called alcohol.  For some people, alcohol is a physically and emotionally addictive drug.  Al-Anon was the second 12-step program to be developed.  It is a recovery program for the family and friends of alcoholics, and focuses on recovery from the compulsive behaviors generated by trying to cope with a loved one's alcoholism.  Some call alcoholism a "family disease" because almost everyone in the family of an alcoholic develop certain ways of thinking, feeling, and acting that may originally have served to protect the family members but soon begin to interfere with each person's ability to function fully in the world.

Other12-step programs have been developed to focus on other drugs or compulsive behaviors.  There are programs for people addicted to narcotics, nicotine, and refined sugar; and programs for persons engaging in compulsive behaviors such as overeating, gambling, gaming, sex, love, emotion, shopping, Internet use, pornography, and so forth.  Further, there are 12-step programs for people with dual diagnoses (for example, addiction/compulsion combined with a mental disorder such as depression).

The common denominator in all these programs is that the participants find themselves using something or someone outside themselves to change how they feel.  Twelve-step programs are based on the premise that inner serenity comes when people find a way to live without addictive and compulsive behaviors.  Active members of 12-step programs find that their lives get better as a result of participation in the group process, a dynamic as complex as human nature.

Myths and Common Concerns

They are a bunch of losers.  This myth comes in many forms, from the belief that meetings are made up of skuzzy old farts in dirty trench coats, to the assumption that all attendees are there because they were ordered by the court to go.  Those in denial about their own problem might assume that only people who can't "hold their liquor" or are "stupid enough to get caught" attend meetings.  There is a common myth that AA is some form agnostics, and people of all faiths feel comfortable in AA.

Another fallacy driving this myth is that addiction is a moral deficiency rather than a disease.  Although the American Medical Association acknowledged that alcoholism is a disease in 1956, and former U.S. Surgeon General C. Everett Koop declared nicotine addiction to be a public health issue, there are still folks out there who consider quitting being no more than a matter of willpower.  For those who have never been addicted, it can be hard to understand that addiction is a disease needing treatment, the disease may not be cured, but the quality and length of life can be greatly enhanced.

As for the "losers" who attend meetings, members include state supreme court justices, former governors, senior corporate executives, financially successful entrepreneurs, managing partners of nationally known law members include felons who have served their time; functionally illiterate people who struggle to read the literature; and people who have lost their jobs, homes, and families as they spiraled down through their disease.  There is no "typical" member of a 12-step group.  Addiction is an equal opportunity disease.