12 Step

The 12 Step Program

Twelve Step programs are well known for use in recovery from addictive or dysfunctional behaviors. The first 12 step program began with Alcoholics Anonymous (A.A.) in the 1930s. The 12 Step approach has since grown to be the most widely used approach in dealing with not only alcoholism, but also drug abuse and various other addictive or dysfunctional behaviors.  Alcoholics Anonymous (AA), the first twelve-step fellowship, was founded in 1935 by Bill Wilson and Dr. Bob Smith, known to AA members as "Bill W." and "Dr. Bob", in Akron, Ohio. They established the tradition within the "anonymous" twelve-step programs of using only first names "at the level of press, radio and film." As AA was growing in the 1930s and 1940s, definite guiding principles began to emerge as the Twelve Traditions. A Singleness of purpose emerged as Tradition Five: "Each group has but one primary purpose -- to carry its message to the alcoholic who still suffers." Consequently, drug addicts who do not suffer from the specifics of alcoholism involved in AA hoping for recovery technically are not welcome in "closed" meetings unless they have a desire to stop drinking alcohol. The reason for such emphasis on alcoholism as the problem is to overcome denial and distraction. Thus the principles of AA have been used to form many numbers of other fellowships for those recovering from various pathologies, each of which in turn emphasizes recovery from the specific malady which brought the sufferer into the fellowship. In 1953 AA gave permission for Narcotics Anonymous to use its Steps and Traditions. In the twelve-step program human structure is symbolically represented in three dimensions: physical, mental, and spiritual. The problems the groups deal with are understood to manifest themselves in each dimension. For addicts and alcoholics the physical dimension is best described by the allergy-like bodily reaction resulting in the compulsion to continue using substances after the initial use. For groups not related to substance abuse this physical manifestation could be more varied including, but not limited to: compulsive hoarding, distractibility, eating disorders, dysfunctional enabling, hyperactivity, hypomania, insomnia, irritability, lack of motivation, laziness, mania, panic attacks, psychosomatic illnesses, poor impulse control, procrastination, self-injury and suicide attempts.

The statement in the First Step that the individual is "powerless" over the substance-abuse related behavior at issue refers to the lack of control over this compulsion, which persists despite any negative consequences that may be endured as a result. The mental obsession is described as the cognitive processes that cause the individual to repeat the compulsive behavior after some period of abstinence, either knowing that the result will be an inability to stop or operating under the delusion that the result will be different.